Our Summary

The study looks at how to diagnose and manage adnexal masses, which are mostly benign growths that occur in the ovaries, fallopian tubes, and surrounding tissues, during pregnancy. These masses are becoming more common due to the increased use of antenatal ultrasound. The main aim was to find out how to differentiate between benign and malignant masses, understand the types of adnexal masses, and look at the complications and management options for these masses during pregnancy.

Findings showed that ultrasound can help to identify whether an adnexal mass is benign or malignant. This information can help doctors decide whether to opt for conservative management, like monitoring the mass, or surgical removal. Historically, surgical removal was the go-to option to avoid complications during pregnancy. However, as our knowledge has increased, benign masses are often managed conservatively. When surgery is required, minimally invasive techniques like laparoscopy and robotic surgery are increasingly used due to their lower risk of complications.

The study concludes that it’s crucial for obstetricians to properly diagnose and manage adnexal masses in pregnancy. If a mass has complex features associated with malignancy, a multidisciplinary approach is recommended, including a referral to a gynecologic oncologist.

FAQs

  1. What are adnexal masses and why are they becoming more common during pregnancy?
  2. How do doctors differentiate between benign and malignant adnexal masses?
  3. What are the management options for adnexal masses during pregnancy, and when is surgery required?

Doctor’s Tip

One helpful tip a doctor might tell a patient about ovarian cyst removal is to discuss all available treatment options and their potential risks and benefits. It’s important for the patient to have a clear understanding of the different management strategies, including conservative monitoring, minimally invasive surgery, or referral to a specialist if there are concerns about malignancy. Additionally, the doctor may advise the patient to closely follow post-operative instructions for a smooth recovery and to report any unusual symptoms or complications promptly.

Suitable For

Patients who are typically recommended ovarian cyst removal include those with:

  1. Large cysts that are causing symptoms such as pelvic pain or pressure
  2. Cysts that are growing rapidly or showing signs of potential malignancy
  3. Cysts that are causing infertility or recurrent miscarriages
  4. Cysts that are persistent and not resolving on their own
  5. Cysts that are causing complications such as torsion or rupture
  6. Patients with a family history of ovarian cancer or other risk factors for malignancy.

Timeline

Before ovarian cyst removal:

  1. Patient experiences symptoms like pelvic pain, bloating, and changes in menstrual cycle.
  2. Patient undergoes imaging tests like ultrasound or MRI to diagnose the ovarian cyst.
  3. Doctor recommends monitoring the cyst or surgical removal based on the size and symptoms.
  4. If surgery is recommended, the patient may undergo pre-operative evaluations and discussions with the surgeon.

After ovarian cyst removal:

  1. Patient undergoes surgical removal of the ovarian cyst through minimally invasive techniques like laparoscopy.
  2. Recovery period post-surgery includes pain management and monitoring for any complications.
  3. Follow-up appointments with the doctor to check for any recurrence of the cyst.
  4. Patient may experience relief from symptoms like pelvic pain and bloating after the cyst is removed.
  5. Patient can resume normal activities gradually as advised by the doctor.

What to Ask Your Doctor

Some questions a patient should ask their doctor about ovarian cyst removal include:

  1. What type of ovarian cyst do I have?
  2. Is the cyst benign or malignant?
  3. What are the risks and benefits of surgical removal?
  4. Are there any non-surgical treatment options available?
  5. What is the recovery process like after surgery?
  6. Will the removal of the cyst affect my fertility?
  7. What are the potential complications of the surgery?
  8. Will I need follow-up appointments after the surgery?
  9. Are there any lifestyle changes I should make after the surgery?
  10. Do I need to see a specialist for further evaluation or treatment?

Reference

Authors: Montes de Oca MK, Dotters-Katz SK, Kuller JA, Previs RA. Journal: Obstet Gynecol Surv. 2021 Jul;76(7):437-450. doi: 10.1097/OGX.0000000000000909. PMID: 34324696