Adnexal masses in pregnancy: Surgery compared with observation
Adnexal masses in pregnancy: Surgery compared with observation
复制标题
DOI：
10.1097/01.aog.0000157465.99639.e5
复制
发表时间：
2005-05-01
影响因子：
7.2
通讯作者：
Gordinier, ME
中科院分区：
文献类型：
--
作者：
Schmeler, KM;Mayo-Smith, WW;Gordinier, ME
目的：探讨妊娠合并附件包块患者延迟手术对母儿预后的影响。方法：对诊断为附件包块直径大于或等于5 cm的孕妇进行分析。收集的数据包括年龄、重力/产次、确诊时的孕周和出现的症状。对超声检查的肿块大小和复杂性进行评估。对妊娠结局、并发症和手术病理进行回顾。结果：1990-2003年间，共有127,177例产妇在本院分娩。63例(0.05%)患者的附件肿块直径大于或等于5厘米。59例(94%)患者有病理诊断。其余4名患者失去了随访，被排除在分析之外。17名患者(29%)进行了产前手术：13名患者的超声检查提示为恶性，4名患者继发于卵巢扭转。观察其余患者，在产后或剖腹产时进行手术。肿块以皮样囊肿为主(42%)。4例患者被诊断为卵巢癌(占肿块的6.8%，分娩的0.0032%)，1例(1.7%)为低恶性潜能肿瘤。所有5名被诊断为恶性肿瘤或交界性肿瘤的女性都进行了产前手术，而良性肿瘤患者中只有12名(22%)(P
OBJECTIVE: To estimate whether the delay of surgery impacts the risk of adverse maternal and fetal outcomes in patients diagnosed with an adnexal mass during pregnancy.METHODS: A review was performed of pregnant patients diagnosed with an adnexal mass 5 cm or greater in diameter. Data collected included age, gravity/parity, gestational age at diagnosis, and presenting symptoms. Ultrasound examinations were evaluated for mass size and complexity. Pregnancy outcome, complications, and surgical pathology were reviewed.RESULTS: Between 1990 and 2003, 127,177 deliveries were performed at our institution. An adnexal mass 5 cm in diameter or greater was diagnosed in 63 (0.05%) patients. Pathologic diagnosis was available for 59 (94%) patients. The remaining 4 patients were lost to follow-up and excluded from the analysis. Antepartum surgery was performed in 17 patients (29%): 13 because of ultrasound findings that suggested malignancy and 4 secondary to ovarian torsion. ne remaining patients were observed, with surgery performed in the postpartum period or at time of cesarean delivery. ne majority of masses were dermoid cysts (42%). Four patients were diagnosed with ovarian cancer (6.8% of masses, 0.0032% of deliveries), and one patient (1.7%) had a tumor of low malignant potential. Antepartum surgery due to ultrasound findings that caused concern was performed on all 5 women diagnosed with a malignancy or borderline tumor, compared with 12 (22%) of the patients with benign tumors (P