Clinical Analysis Of31Cases Of Ovarian Tumors Torsion During Pregnancy

Ovarian tumors during pregnancy is a common complication of pregnancy. Once ovarian torsion occurs during pregnancy it can be a direct threat to maternal life. The disease has a characteristics of rapid onset, rapid progression, clinical manifestations of complex and diverse, and easily lead to misdiagnosis. Cases in pregnancy are more severe than ones in non-pregnancy. So the mother and fetus must be considered during treatment. Thus, summarizing the clinical manifestations, diagnosis, treatment of ovarian tumors torsion in pregnancy is very necessary. Collecting clinical data of31cases of pregnant women with ovarian tumors torsion from January2006to February2013in the PLA202Hospital and combining with relevant literature, we analyzed the clinical data to attempt to explore the clinical characteristics, diagnosis, treatment and its effects on pregnancy outcome of ovarian tumors torsion during pregnancy. At the same time explore the effects of first high ligation of the ovarian artery and vein, and then reset to reverse attachments and remove the ovarian tumor. Then to investigate the safety of laparoscopic surgery for the treatment of ovarian cyst torsion during pregnancy.Objective:To discuss the clinical features, diagnosis, treatment and its effects on pregnancy outcome of ovarian tumors torsion during pregnancy, and attempt to improve the level of diagnosis and treatment of this disease. Methods:Clinical data of31cases of ovarian tumors torsion during pregnancy was collected from January2006to February2013admitted to the PLA202Hospital, using retrospective analysis.Results:31patients had two cases of conventional treatment,29cases of surgical treatment. In one case before surgery were misdiagnosed as appendicitis.19cases of open surgery (9cases of taking high ligation of the ovarian artery and vein, keeping ipsilateral ovary procedure, and10cases of taking conventional surgical resection of the affected attachment), and10cases laparoscopic surgery (five cases of taking high ligation of ovarian artery and vein of the new technique, five cases of taking conventional surgical resection of the affected attachment). Four cases occurred in the first trimester (<14weeks), accounting for12.9%;25cases occurs in the second trimester (14weeks to28weeks), accounting for80.6%;2cases occurs in the third trimester (>28weeks), accounting for6.5%.29cases of benign, non-malignant tumor, intraoperative exploration ovarian tumor size in4-14cm, averaging7.31+2.66cm. The most common histological type was a total of14cases of teratoma (48.3%), followed by a total of six cases of serous cystadenoma (20.7%), corpus luteum cyst or luteinizing total of four patients (13.8%), mucinous cystadenoma total3cases (10.3%), endometrial cyst totaling2cases (6.9%). There are24cases of full-term delivery in29cases surgery patients, three cases of premature birth, two cases of abortion. There is one case of conventional treatment term delivery, omit one case of miscarriage.Conclusion:Torsion of ovarian tumors in pregnancy is prone to be misdiagnosed because of their special physiological and anatomical changes, so the diagnosis and treatment of multiple departments need to work closely with the Senate. The most common histological type of the disease is mature cystic teratoma, followed by serous cystadenoma, omit luteinizing corpus luteum cyst, mucinous cystadenoma and endometrial cyst. Torsion of ovarian tumors in pregnancy likely to occur in the second trimester, the event should be immediately operated. And reasonable surgical approach does not increase the incidence of premature delivery and miscarriage. Exploratory surgery for no obvious infection in patients with benign ovarian tumors torsion, can be applied to high ligation of the ovarian artery and vein, and then twist the ovary after a reset, the final surgical resection of the tumor, which addresses the ovarian lesions, but also retains the ovarian tissue and functions. Laparoscopic surgery can be safely used in the treatment of ovarian cyst torsion in the second trimester.