Clinical Study of Ovarian Tumors in Pregnancy: Observation vs. Surgery

Aim: To estimate the demographical factors and to evaluate the management options i.e. conservative vs surgery in antenatal period.

Methods: The retrospective study was done in Lady Goschen Hospital, Kasturba Medical College, Mangalore. Data retrieved from records section from 1 January 2005 to 31 December 2010, included age, parity, period of gestation at diagnosis, presenting complaints, ultrasound examination, management, pregnancy outcome and histopathological report. Data analysed by chi square test and student’s ‘t’ test.

Results: During the 5 yr study period, an adnexal mass of more than 5 cms was diagnosed in 30 patients, surgery was done in 33% patients antenataly. In 20% patient’s intervention was done during LSCS. 40% of them had surgery during postnatal period. Majority of them were dermoid cysts. Two cases were malignant ovarian tumor, diagnosed after histopathological study. One underwent staging laparotomy and was in stage IA. Other patient lost follow up.

Conclusion: Functional cysts less than 5 cms resolve spontaneously by 6-8 wks. Expectant management is a reasonable option in asymptomatic, non-suspicious cystic ovarian tumor during pregnancy. Surgery is indicated only in large, symptomatic and highly suspicious tumors.