Skip to main content Accessibility help

We use cookies to distinguish you from other users and to provide you with a better experience on our websites. Close this message to accept cookies or find out how to manage your cookie settings.

Close cookie message
×
Hostname: page-component-848d4c4894-8kt4b Total loading time: 0 Render date: 2024-06-22T03:55:20.175Z Has data issue: false hasContentIssue false

Chapter 1 - Ovarian Cysts in Pregnancy

Published online by Cambridge University Press:  14 July 2023

By
Masha Ben Zvi ,
Nikolaos Thanatsis  and
Arvind Vashisht
Edited by
Swati Jha  and
Priya Madhuvrata
Swati Jha
Affiliation:
Sheffield Teaching Hospital NHS Foundation Trust
Priya Madhuvrata
Affiliation:
Sheffield Teaching Hospital NHS Foundation Trust
Get access

Summary

The establishment of ultrasonography in daily gynaecological and obstetric practice has increased the rate of diagnosis of ovarian cysts amongst pregnant women. Both assessment and management of ovarian cysts in pregnancy can be challenging. Although most cysts are functional in nature and a conservative approach can be employed, a small proportion will carry some malignant potential. Identifying which cysts can be safely managed expectantly and which necessitate surgical intervention, investigating possible cyst accidents, deciding on the timing and nature of intervention (fine needle aspiration versus cystectomy or even oophorectomy), the surgical approach (laparotomy versus laparoscopy) and balancing the risks and benefits for the mother and the fetus are just a few examples of the dilemmas that need to be addressed, ideally within a multidisciplinary team-based environment.

Keywords

pregnancyovarian cystovarian torsionultrasoundlaparoscopy in pregnancy
Type
Chapter
Information
Gynaecology for the Obstetrician , pp. 1 - 13
Publisher: Cambridge University Press
Print publication year: 2023

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Schwartz, N., Timor-Tritsch, I. E. and Wang, E.. Adnexal masses in pregnancy. Clinical Obstetrics and Gynecology, 52 (2009), 570–85.CrossRefGoogle ScholarPubMed
Webb, K. E., Sakhel, K., Chauhan, S. P. and Abuhamad, A. Z.. Adnexal mass during pregnancy: A review. American Journal of Perinatology, 32 (2015), 1010–16.Google Scholar
Schmeler, K. M., Mayo-Smith, W. W., Peipert, J. F., et al. Adnexal masses in pregnancy: Surgery compared with observation. Obstetrics and Gynecology, 105 (2005), 1098–103.CrossRefGoogle ScholarPubMed
Condous, G., Khalid, A., Okaro, E. and Bourne, T.. Should we be examining the ovaries in pregnancy? Prevalence and natural history of adnexal pathology detected at first-trimester sonography. Ultrasound in Obstetrics & Gynecology: The Official Journal of the International Society of Ultrasound in Obstetrics and Gynecology, 24 (2004), 62–6.CrossRefGoogle ScholarPubMed
Bottomley, C. and Bourne, T.. Diagnosis and management of ovarian cyst accidents. Best Practice & Research Clinical Obstetrics & Gynaecology, 23 (2009), 711–24.Google Scholar
Alalade, A. O. and Maraj, H.. Management of adnexal masses in pregnancy. Obstetrician & Gynaecologist, 19 (2017), 317–25.Google Scholar
Huang, C., Hong, M. K. and Ding, D. C.. A review of ovary torsion. Ci ji yi xue za zhi = Tzu-chi Medical Journal, 29 (2017), 143–7.Google Scholar
Yen, C. F., Lin, S. L., Murk, W., et al. Risk analysis of torsion and malignancy for adnexal masses during pregnancy. Fertility and Sterility, 91 (2009), 1895–902.CrossRefGoogle ScholarPubMed
Graif, M. and Itzchak, Y.. Sonographic evaluation of ovarian torsion in childhood and adolescence. American Journal of Roentgenology, 150 (1988), 647–9.Google Scholar
Senarath, S., Ades, A. and Nanayakkara, P.. Ovarian cysts in pregnancy: A narrative review. Journal of Obstetrics and Gynaecology: The Journal of the Institute of Obstetrics and Gynaecology, 41 (2021), 169–75.Google Scholar
Eskander, R., Berman, M. and Keder, L.. Practice Bulletin No. 174: Evaluation and management of adnexal masses. Obstetrics and Gynecology, 128 (2016), e210–e26.Google Scholar
Sokalska, A., Timmerman, D., Testa, A. C., et al. Diagnostic accuracy of transvaginal ultrasound examination for assigning a specific diagnosis to adnexal masses. Ultrasound in Obstetrics & Gynecology: The Official Journal of the International Society of Ultrasound in Obstetrics and Gynecology, 34 (2009), 462–70.Google Scholar
Kaloo, P., Louden, K., Khazali, S. and Hoy, D.. RCOG/BSGE National Green Top Guidelines No: 62, ‘Management of Suspected Ovarian Masses in Premenopausal Women’. (November 2011).Google Scholar
Yazbek, J., Raju, S. K., Ben-Nagi, J., et al. Effect of quality of gynaecological ultrasonography on management of patients with suspected ovarian cancer: A randomised controlled trial. Lancet Oncology, 9 (2008), 124–31.CrossRefGoogle ScholarPubMed
Timmerman, D., Testa, A. C., Bourne, T., et al. Simple ultrasound-based rules for the diagnosis of ovarian cancer. Ultrasound in Obstetrics & Gynecology: The Official Journal of the International Society of Ultrasound in Obstetrics and Gynecology, 31 (2008), 681–90.Google Scholar
Ameye, L., Timmerman, D., Valentin, L., et al. Clinically oriented three-step strategy for assessment of adnexal pathology. Ultrasound in Obstetrics & Gynecology: The Official Journal of the International Society of Ultrasound in Obstetrics and Gynecology, 40 (2012), 582–91.CrossRefGoogle ScholarPubMed
Pateman, K., Moro, F., Mavrelos, D., et al. Natural history of ovarian endometrioma in pregnancy. BMC Women’s Health, 14 (2014), 128.Google Scholar
Adusumilli, S., Hussain, H. K., Caoili, E. M., et al. MRI of sonographically indeterminate adnexal masses. American Journal of Roentgenology, 187 (2006), 732–40.CrossRefGoogle ScholarPubMed
Ball, E., Waters, N., Cooper, N., et al. Evidence-based guideline on laparoscopy in pregnancy: Commissioned by the British Society for Gynaecological Endoscopy (BSGE), endorsed by the Royal College of Obstetricians & Gynaecologists (RCOG). Facts, Views & Vision in ObGyn, 11 (2019), 5–25.Google Scholar
Aslam, N., Ong, C., Woelfer, B., Nicolaides, K. and Jurkovic, D.. Serum CA125 at 11–14 weeks of gestation in women with morphologically normal ovaries. BJOG: An International Journal of Obstetrics and Gynaecology, 107 (2000), 689–90.Google Scholar
Guariglia, L., Conte, M., Are, P. and Rosati, P.. Ultrasound-guided fine needle aspiration of ovarian cysts during pregnancy. European Journal of Obstetrics, Gynecology, and Reproductive Biology, 82 (1999), 5–9.CrossRefGoogle ScholarPubMed
Chen, L., Ding, J. and Hua, K.. Comparative analysis of laparoscopy versus laparotomy in the management of ovarian cyst during pregnancy. Journal of Obstetrics and Gynaecology Research, 40 (2014), 763–9.Google Scholar
Liu, Y. X., Zhang, Y., Huang, J. F. and Wang, L.. Meta-analysis comparing the safety of laparoscopic and open surgical approaches for suspected adnexal mass during the second trimester. International Journal of Gynaecology and Obstetrics: The Official Organ of the International Federation of Gynaecology and Obstetrics, 136 (2017), 272–9.Google Scholar
Candiani, M., Maddalena, S., Barbieri, M., et al. Adnexal masses in pregnancy: Fetomaternal blood flow indices during laparoscopic surgery. Journal of Minimally Invasive Gynecology, 19 (2012), 443–7.CrossRefGoogle ScholarPubMed
Reedy, M. B., Källén, B. and Kuehl, T. J.. Laparoscopy during pregnancy: A study of five fetal outcome parameters with use of the Swedish Health Registry. American Journal of Obstetrics and Gynecology, 177 (1997), 673–9.Google Scholar
Pearl, J. P., Price, R. R., Tonkin, A. E., Richardson, W. S. and Stefanidis, D.. SAGES guidelines for the use of laparoscopy during pregnancy. Surgical Endoscopy, 31 (2017), 3767–82.Google Scholar
Cagino, K., Li, X., Thomas, C., et al. Surgical management of adnexal masses in pregnancy: A systematic review and meta-analysis. Journal of Minimally Invasive Gynecology, 28 (2021), 1171–82.Google Scholar
Mukhopadhyay, A., Shinde, A. and Naik, R.. Ovarian cysts and cancer in pregnancy. Best Practice & Research Clinical Obstetrics & Gynaecology, 33 (2016), 58–72.Google Scholar
Weiner, E., Mizrachi, Y., Keidar, R., et al. Laparoscopic surgery performed in advanced pregnancy compared to early pregnancy. Archives of Gynecology and Obstetrics, 292 (2015), 1063–8.Google Scholar
National Collaborating Centre for Women’s and Children’s Health. Preterm Labour and Birth. (London: National Institute for Health and Care Excellence, 2015).Google Scholar

Save book to Kindle

To save this book to your Kindle, first ensure coreplatform@cambridge.org is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about saving to your Kindle.

Note you can select to save to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be saved to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

Find out more about the Kindle Personal Document Service.

Available formats
×

Save book to Dropbox

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Dropbox.

Available formats
×

Save book to Google Drive

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Google Drive.

Available formats
×