Laparoscopic management of ovarian masses during pregnancy
Keywords:
Adnexal mass; pregnancy; laparoscopy.Abstract
Background: The diagnosis of an adnexal mass associated with pregnancy is increasingly common with the routine use of ultrasound during prenatal care.aim: To assess the feasibility, advantages and limiting factors of laparoscopy in the management of ovarian masses during pregnancy.
methods: Rretrospective study of a series of 34 pregnant women operated by laparoscopy for adnexal masses during a period of 14 years.
results: The mean age of patients was 29 years. Fifty percent of patients were nulliparous. In 62% of cases, patients were asymptomatic. Laparoscopy was performed at a mean gestational age of 15 weeks. Open laparoscopy was performed in 58.8% of cases. Intraperitoneal cystectomy was performed in 28 cases (72%). In two cases (5 %), it was a borderline ovarian tumor requiring further surgery outside of pregnancy. Fetal loss was noted at a term of 16 weeks.
Conclusion: Laparoscopic management of adnexal masses during pregnancy appears to be safe and reproducible procedure with few maternal and fetal complications.
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References
Kort B, Katz V L, Watson WJ. The effect of non obstetric operation during pregnany. Surg gynecol obstet 1993; 177: 371-6.
Morice P, Louis-Sylvestre C, Chapron C, Dubuisson JB. Laparoscopic surgery of ovarian tumors during pregnancy. Contracept Fertil Sex. 1997; 25:375-9.
Sherard GB, Hodson CA, Williams HJ, Semer DA, Hadi HA, Tait DL. Adnexal masses and pregnancy: a 12-year experience. Am J Obstet Gynecol 2003, 89:358-62.
Purnichescu V, Cheret-Benoist A, Von Theobald P, Mayaud A, Herlicoviez M, Dreyfus M. Laparoscopic management of pelvic mass in pregnancy. J Gynecol Obstet Biol Reprod 2006; 35: 388-95.
Lenglet Y, Roman H, Rabishong B, et al. Traitement coelioscopique des kystes de l'ovaire au cours de la grossesse. Gynécol Obstét Fertil 2006; 34: 101-6.
Boughizane S, Naifer R, Hafsa A et al. Le traitement coeliochirurgical des tumeurs des annexes de l'utérus après le premier trimestre de la grossesse. J Gynecol Obstet Biol Reprod 2004; 33: 319-24.
Zanetta G, Mariani E, Lissoni A et al. A prospective study of the role of ultrasound in the management of adnexal masses in pregnancy. Br J Obstet Gynecol 2003; 110: 578-83.
Patacchiola F, Collevecchio N, Di Ferdinando A, Palermo P, Di Stefano L, Mascaretti G. Management of ovarian cysts in pregnancy: a case report. Eur J Gynaecol Oncol. 2005; 26:651-3.
Hess L W, Peaceman A, O'Brien W F, Winkel C A, Cruikshauc D P, Morison J C. Adnexal mass occurring with intrauterine pregnancy: report of fifty-four patients requiring laparotomy for definitive management. Am J Obstet Gynecol 1988; 158: 1029-34.
Al-Fozan H, Tulandi T. Safety and risks of laparotomy in pregnancy. Curr Opin Obstet Gynecol 2002; 14:345-49.
Schmeler KM, Mayo-Smith WW, Peipert JF, Weitzen S, Manuel MD, Gordinier ME. Adnexal masses in pregnancy: surgery compared with observation. Obstet Gynecol 2005; 105: 1098-103.
Bignardi T, Condous G. The management of ovarian pathology in pregnancy. Best Pract Res Clin Obstet Gynaecol 2009; 23 :539-48.
Morice P, Lhomme C, Lecuru F et al. Recommandations pour la prise en charge du cancer de l'ovaire pendant la grossesse. Mises à jour en gynécologie obstétrique. Collège National des gynécologues et obstétriciens Français. Michel Tournaire Ed 2009; 231-235.
Kumari I, Kaur S, Mohan H, Huria A. Adnexal masses in pregnancy: a 5-year review. Aust N Z J Obstet Gynaecol 2006; 46: 52-54.
Glanc P , Brofman N, Salem S, Kornecki A, Abrams J, Farine D. The prevalence of incidental simple ovarian cysts>or=3 cm detected by transvaginalsonography in early pregnancy. J Obstet Gynaecol Can 2007; 29: 502-6.
Slim K., Canis M. Chirurgie sous coelioscopie et grossesse. J.Chir.1998 ; 135 : 261-66.
Graham G, Baxi l, Tharakan T. Laparoscopic cholecystectomy during pregnancy: a case series and review of the literature. Obstet Gynecol Surv 1998; 53: 566-74.
Moore R D, Gray S, Laparoscopic management of adnexal masses in pregnant women. J Reprod Med 1999, 44: 97-100.
Goffinet F. Ovarian cysts and pregnancy. J Gynecol Obstet Biol Reprod 2001; 30: S100-8.
Howard FM, Vill M. Laparoscopic adnexal surgery during pregnancy. J Am Assoc Gynecol Laparosc 1994; 2: 91-3.
Balci O, Gezginc K, Karatayli R, Acar A, Celik C, Colakoglu MC. Management and outcomes of adnexal masses during pregnancy: a 6-year experience. J Obstet Gynaecol Res. 2008; 34:524-8.
Mathevet P, Nessah K, Dargent D, Mellier G. Laparoscopic management of adnexal masses in pregnancy: a case series. Eur J Obstet Gynecol Reprod Biol 2003; 108: 217-22.
