Clinical Treatment Of Ovarian Tumors In Pregnancy

Background With the increasing awareness of eugenics and perinatal health care,the development of prenatal examination technology such as B-ultrasound examination and the increase of cesarean section rate.The detection rate of pregnancy complicated with ovarian masses has increased year by year.The enlarged uterus in the middle and late stages of pregnancy may cover the adnexal masses,resulting in the twisted and rupture of the mass.It even affects the judgment of benign and malignant ovarian tumor.During pregnancy,there is a certain risk of intervention on ovarian tumor.Surgical treatment may lead to pregnancy abortion,secondary bleeding,hysterectomy and other complications.How to diagnose and choose the appropriate treatment in time has become the focus of clinical research.Objective This study aimed to investigate the clinical characteristics of pregnancy associated with ovarian tumors and evaluate the impact of surgical intervention during pregnancy on pregnancy outcomes.Methods Retrospective analysis has been done on the clinical data of 176 cases with ovarian asses during pregnancy who had been treated,operated and pathologically diagnosed in the Obstetrics and Gynecology Hospital affiliated to Nanjing Medical University between January 2012 to December 2016.Results The onset age of the patients was21~ 43 years old,with an average age of29.4 ± 4.1 years.The gestation times were 1~5 times,the average was 1.6 ± 0.97 times.The primiparas 139 cases,and the parturients 37 cases.The diameter of the tumors was 2 to 31 cm,averaging(7.9 ± 4.4)cm.People were divided into three groups according to the diameter of ovarian tumors.34 cases were less than 5cm,112 cases were between 5 and 10 cm,30 cases were more than 10 cm and the corresponding morbidity were 0%,13.4% and 16.7%.With significant difference between them(P<0.05).Emergency operations were done on 20 patients with complications.During the operation,17 patients were found to have torsion of the ovarian tumor pedicle,among which,4 patients undertook the ipsilateral enuclearion of ovarian tumors without no ovarian necrosis,13 patients undertook ipsilateral ovarian attachment resection due to ovarian necrosis.2 cases of acute lower abdominal pain combined with ovarian tumor rupture,of which one patient suffered from side adnexectomy,and the other underwent excision of ovarian masses on the affected side.1 patient undertook right side attachment resection due to bloating with high suspicion of malignancy.Except for 35 patients who lost their visits after operation in the second trimester of pregnancy,the pregnancy outcomes of 141 cases showed that 131 cases of term delivery,9 cases of premature delivery and 1 case of abortion.Conclusion Pregnant patient with ovarian benign tumors should be alert to the occurrence of complications and surgical intervention during pregnancy is safe and feasible.