Clinical Analysis Of 271 Cases Of Pregnancy With Ovarian Tumor

Background:Due to the improvement of perinatal care and the popularization of diagnostic techniques such as color Doppler ultrasound,more ovarian tumors have been discovered.Uterine enlargement and ovarian tumors coexist during pregnancy.During this period,the tumor is prone to torsion,rupture and other acute abdomen,which will endanger the safety of the mother and child.The diagnosis of pregnancy with ovarian tumors,the identification of benign and malignant tumors,and the timing of surgical intervention have attracted more and more attention.Objective:The discovery time and pathological type of pregnancy with ovarian tumors were analyzed and discussed.The effects of surgical methods and surgical interventions on pregnancy outcomes during pregnancy were also discussed.Methods:Affiliated Hospital of Qingdao University has admitted 271 pregnant women with ovarian tumors from January 2015 to June 2019.All of them were diagnosed by surgical pathology.The clinical data of these patients were analyzed retrospectively.The discovery time and pathological type of pregnancy with ovarian tumors were analyzed and discussed.The effects of surgical methods and surgical interventions on pregnancy outcomes during pregnancy were also discussed.Results:Among the 271 cases,the age of onset was 19-47 years,with an average age of32.89±5.01 years.Patients with ovarian tumors found before pregnancy accounted for19.56%(53/271),patients with ovarian tumors found early in pregnancy accounted for25.46%(69/271),and patients with ovarian tumors found during the second trimester accounted for 6.27%(17/271),patients with ovarian tumors found in late pregnancy accounted for 4.06%(11/271),and patients with ovarian tumors found for the first time in cesarean section accounted for 44.65%(121/271).The diameter of ovarian tumor is 1?40cm,with an average of 7.29±4.05 cm.There were 112 cases in the ovarian tumor diameter group less than 5cm.There were 142 cases of ovarian tumors with diameters ranging from 5 to 10 cm.There were 17 cases in the group with ovarian tumor diameter> 10 cm.The complicationrates of the three groups were 1.78%(2/112),20.42%(29/142)and 29.41%(5/17).The difference between each of the three groups was statistically significant(P<0.05).Among various pathological types,260 cases(95.94%)were benign ovarian tumors,and more common were mature cystic teratoma,a total of 121 cases(44.65%).Followed by 49 cases of endometriotic cysts(18.08%).There were 37 cases(13.65%)of serous cystadenoma.There were 35 cases(12.92%)of mucinous cystadenoma.There were 8 cases(2.95%)of borderline tumors,including 2 cases of pregnancy with borderline mucinous cystadenoma and 6 cases of borderline ovarian serous tumor.There were 3 cases(1.11%)of malignant tumors,including 1 case of Sertoli-leydig cell tumor(medium differentiation)in pregnancy and 2 cases of metastatic tumor.Of the 271 cases,16 patients were lost to follow-up after surgical intervention before 28 weeks of pregnancy.There were 6 cases of surgical intervention in early pregnancy,including 5 cases of full-term delivery and 1 case of miscarriage.There were 59 cases of surgical intervention in mid-pregnancy,including 56 cases of full-term delivery,2 cases of premature delivery,and 1 case of miscarriage.There was one case of intervention in the third trimester,and the outcome was premature delivery.There were 189 cases of cesarean section intervention,including 176 cases delivered to full term,and 13 cases of premature delivery.Conclusion:Early diagnosis of ovarian tumors during pregnancy is very important.Ultrasound examination is a reliable and easy inspection method.Ovarian tumors are found to continue pregnancy.If you suspect the presence of malignant ovarian tumors,you can intervene as soon as possible.Tumor markers have limited diagnostic value for ovarian tumors during pregnancy.The clinical manifestations of pregnancy with ovarian tumors are not specific.The pathological types of pregnancy with ovarian tumors are mature teratoma,endometriotic cyst,and serous mucinous cystadenoma.Ovarian tumors of more than 5 cm in diameter during pregnancy continue to exist,and be alert for acute abdomen.Surgical intervention during pregnancy is safe and feasible,and has no obvious effect on pregnancy outcome.Laparoscopic surgery or transabdominal surgery is the surgical method of choice.Laparoscopic surgery may be better than open surgery.