Generic placeholder image

Current Women`s Health Reviews

Editor-in-Chief

ISSN (Print): 1573-4048
ISSN (Online): 1875-6581

Review Article

Adnexal Masses in Pregnancy: A Review

Author(s): Megan Pagan*, Heather Jinks and Karen Wilson

Volume 15, Issue 1, 2019

Page: [57 - 63] Pages: 7

DOI: 10.2174/1573404814666180613093107

Price: $65

Abstract

Diagnosis of adnexal masses in pregnancy has been increasing due to the routine use of obstetric ultrasound examinations. The clinical course varies widely based on the symptomatology, gestational age and ultrasound characteristics of the adnexal mass. Most adnexal masses identified in pregnancy are benign and resolve spontaneously. Complications, although relatively rare, can occur and include torsion, rupture and malignancy. This review will discuss the epidemiology, diagnosis, evaluation and management of adnexal masses during pregnancy.

Keywords: Adnexal mass, ovarian cyst, pregnancy, adnexal torsion, ovarian torsion, tumor markers in pregnancy, ovarian malignancy in pregnancy, adnexal ultrasound characteristics.

Graphical Abstract
[1]
Leiserowitz GS. Managing ovarian masses during pregnancy. Obstet Gynecol Surv 2006; 61(7): 463-70.
[2]
Leiserowitz GS, Xing G, Cress R, Brahmbhatt B, Dalrymple JL, Smith LH. Adnexal masses in pregnancy: how often are they malignant? Gynecol Oncol 2006; 101(2): 315-21.
[3]
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(5 Pt 1): 1098-103.
[4]
Webb KE, Sakhel K, Chauhan SP, Abuhamad AZ. Adnexal mass during pregnancy: a review. Am J Perinatol 2015; 32(11): 1010-6.
[5]
Smith LH, Dalrymple JL, Leiserowitz GS, Danielsen B, Gilbert WM. Obstetrical deliveries associated with maternal malignancy in California, 1992 through 1997. Am J Obstet Gynecol 2001; 184(7): 1504-12. discussion 1512-3
[6]
Condous G, Khalid A, Okaro E, Bourne T. Should we be examining the ovaries in pregnancy? Prevalence and natural history of adnexal pathology detected at first-trimester sonography. Ultrasound Obstet Gynecol 2004; 24(1): 62-6.
[7]
Goh WA, Rincon M, Bohrer J, et al. Persistent ovarian masses and pregnancy outcomes. J Matern Fetal Neonatal Med 2013; 26(11): 1090-3.
[8]
Baser E, Erkilinc S, Esin S, et al. Adnexal masses encountered during cesarean delivery. Int J Gynaecol Obstet 2013; 123(2): 124-6.
[9]
Hogston P, Lilford RJ. Ultrasound study of ovarian cysts in pregnancy: prevalence and significance. Br J Obstet Gynaecol 1986; 93(6): 625-8.
[10]
Bernhard LM, Klebba PK, Gray DL, Mutch DG. Predictors of persistence of adnexal masses in pregnancy. Obstet Gynecol 1999; 93(4): 585-9.
[11]
Giuntoli RL 2nd, Vang RS, Bristow RE. Evaluation and management of adnexal masses during pregnancy. Clin Obstet Gynecol 2006; 49(3): 492-505.
[12]
Machado F, Vegas C, Leon J, et al. Ovarian cancer during pregnancy: analysis of 15 cases. Gynecol Oncol 2007; 105(2): 446-50.
[13]
Goff BA, Mandel LS, Melancon CH, Muntz HG. Frequency of symptoms of ovarian cancer in women presenting to primary care clinics. JAMA 2004; 291(22): 2705-12.
[14]
Goff BA, Mandel LS, Drescher CW, et al. Development of an ovarian cancer symptom index: possibilities for earlier detection. Cancer 2007; 109(2): 221-7.
[15]
Yen CF, Lin SL, Murk W, et al. Risk analysis of torsion and malignancy for adnexal masses during pregnancy. Fertil Steril 2009; 91(5): 1895-902.
[16]
Sarandakou A, Protonotariou E, Rizos D. Tumor markers in biological fluids associated with pregnancy. Crit Rev Clin Lab Sci 2007; 44(2): 151-78.
[17]
Bromley B, Benacerraf B. Adnexal masses during pregnancy: accuracy of sonographic diagnosis and outcome. J Ultrasound Med 1997; 16(7): 447-52.
[18]
Whitecar MP, Turner S, Higby MK. Adnexal masses in pregnancy: a review of 130 cases undergoing surgical management. Am J Obstet Gynecol 1999; 181(1): 19-24.
[19]
Soriano D, Yefet Y, Seidman DS, Goldenberg M, Mashiach S, Oelsner G. Laparoscopy versus laparotomy in the management of adnexal masses during pregnancy. Fertil Steril 1999; 71(5): 955-60.
[20]
American College of Obstetricians and Gynecologists’ Committee on Practice Bulletins—Gynecology. Practice Bulletin No. 174: Evaluation and Management of Adnexal Masses. Obstet Gynecol 2016; 128(5): e210-26.
[21]
Givens V, Mitchell GE, Harraway-Smith C, Reddy A, Maness DL. Diagnosis and management of adnexal masses. Am Fam Physician 2009; 80(8): 815-20.
[22]
Brown DL, Dudiak KM, Laing FC. Adnexal masses: US characterization and reporting. Radiology 2010; 254(2): 342-54.
[23]
Curtis M, Hopkins MP, Zarlingo T, Martino C, Graciansky-Lengyl M, Jenison EL. Magnetic resonance imaging to avoid laparotomy in pregnancy. Obstet Gynecol 1993; 82(5): 833-6.
[24]
Kaijser J, Van Gorp T, Smet ME, et al. Are serum HE4 or ROMA scores useful to experienced examiners for improving characterization of adnexal masses after transvaginal ultrasonography? Ultrasound Obstet Gynecol 2014; 43(1): 89-97.
[25]
Goh W, Bohrer J, Zalud I. Management of the adnexal mass in pregnancy. Curr Opin Obstet Gynecol 2014; 26(2): 49-53.
[26]
Mom CH, Engelen MJ, Willemse PH, et al. Granulosa cell tumors of the ovary: the clinical value of serum inhibin A and B levels in a large single center cohort. Gynecol Oncol 2007; 105(2): 365-72.
[27]
Yoshida A, Derchain SF, Pitta DR, Andrade LA, Sarian LO. Comparing the Copenhagen Index (CPH-I) and Risk of Ovarian Malignancy Algorithm (ROMA): Two equivalent ways to differentiate malignant from benign ovarian tumors before surgery? Gynecol Oncol 2016; 140(3): 481-5.
[28]
Moore RG, McMeekin DS, Brown AK, et al. A novel multiple marker bioassay utilizing HE4 and CA125 for the prediction of ovarian cancer in patients with a pelvic mass. Gynecol Oncol 2009; 112(1): 40-6.
[29]
Ercan Ş, Kaymaz Ö, Yücel N, Orçun A. Serum concentrations of CA 125, CA 15-3, CA 19-9 and CEA in normal pregnancy: a longitudinal study. Arch Gynecol Obstet 2012; 285(3): 579-84.
[30]
Han SN, Lotgerink A, Gziri MM, Van Calsteren K, Hanssens M, Amant F. Physiologic variations of serum tumor markers in gynecological malignancies during pregnancy: a systematic review. BMC Med 2012; 10: 86.
[31]
Koo YJ, Kim TJ, Lee JE, et al. Risk of torsion and malignancy by adnexal mass size in pregnant women. Acta Obstet Gynecol Scand 2011; 90(4): 358-61.
[32]
Hasson J, Tsafrir Z, Azem F, et al. Comparison of adnexal torsion between pregnant and nonpregnant women. Am J Obstet Gynecol 2010; 202(6): 536.e1-6.
[33]
Barakat RR. Principles and practice of gynecologic oncology. Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins 2013.
[34]
Bakri YN, Ezzat A. Akhtar, Dohami, Zahrani. Malignant germ cell tumors of the ovary. Pregnancy considerations. Eur J Obstet Gynecol Reprod Biol 2000; 90(1): 87-91.
[35]
Grimm D, Woelber L, Trillsch F, Keller-v Amsberg G, Mahner S. Clinical management of epithelial ovarian cancer during pregnancy. Eur J Cancer 2014; 50(5): 963-71.
[36]
Gezginç K, Karataylı R, Yazıcı F, Acar A, Celik C, Capar M. Ovarian cancer during pregnancy. Int J Gynaecol Obstet 2011; 115(2): 140-3.
[37]
Malinowski AK, Sen J, Sermer M. Hyperreactio luteinalis: Maternal and fetal effects. J Obstet Gynaecol Can 2015; 37(8): 715-23.
[38]
Liu YX, Zhang Y, Huang JF, Wang L. Meta-analysis comparing the safety of laparoscopic and open surgical approaches for suspected adnexal mass during the second trimester. Int J Gynaecol Obstet 2017; 136(3): 272-9.
[39]
[No author listed]. Statement on the use of general anesthetics and sedation drugs in children and pregnant women. Bull Am Coll Surg. 2017; 102(4): 39.
[40]
Balthazar U, Steiner AZ, Boggess JF, Gehrig PA. Management of a persistent adnexal mass in pregnancy: what is the ideal surgical approach? J Minim Invasive Gynecol 2011; 18(6): 720-5.
[41]
Ulker V, Gedikbasi A, Numanoglu C, Saygi S, Aslan H, Gulkilik A. Incidental adnexal masses at cesarean section and review of the literature. J Obstet Gynaecol Res 2010; 36(3): 502-5.
[42]
Dede M, Yenen MC, Yilmaz A, Goktolga U, Baser I. Treatment of incidental adnexal masses at cesarean section: a retrospective study. Int J Gynecol Cancer 2007; 17(2): 339-41.

Rights & Permissions Print Cite
© 2024 Bentham Science Publishers | Privacy Policy