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Title: Jurnal Medical Aradean (Arad Medical Journal)
Abbreviated title: J. Med. Ar.
Publisher: "Vasile Goldis" University Press
Owner: Western University "Vasile Goldis" Arad, Romania
ISSN: 1224-3744
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MANAGEMENT OPTIONS FOR ENLARGED OVARIES DETECTED IN THE FIRST TRIMESTER OF PREGNANCY PDF Print E-mail

MANAGEMENT OPTIONS FOR ENLARGED OVARIES DETECTED IN THE FIRST TRIMESTER OF PREGNANCY

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Title: MANAGEMENT OPTIONS FOR ENLARGED OVARIES DETECTED IN THE FIRST TRIMESTER OF PREGNANCY
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Article_Title: MANAGEMENT OPTIONS FOR ENLARGED OVARIES DETECTED IN THE FIRST TRIMESTER OF PREGNANCY
Authors: FURĂU Cristian1,2, FURĂU Gheorghe1,2,TATARU Ana Liana1,2, ONEL Cristina1,2, STĂNESCU Casiana1,2 , CRAINA Marius3,4, DIMITRIU Mihai5
Affiliation: 1 Western University „Vasile Goldis” of Arad
2 Obstetrics and Gynecology Department of the Emergency Clinical County Hospital of Arad
3 „Victor Babes” University of Medicine and Pharmacy Timisoara
4 Bega Clinic for Obstetrics and Gynecology Timisoara
5”Carol Davila” University of Medicine and Pharmacy Bucharest, Obstetrics and Gynecology Department
Abstract: Ovarian cysts have a reported incidence in pregnancy between 1:81 and 1:2500. The development of ultrasound in the first trimester of pregnancy revealed a much higher incidence and although complications are not very frequent, early diagnosis of ovarian cysts is very important for their management. To analyze the incidence and possibilities of management for first trimester enlarged ovaries in pregnancy in Arad County for a period of 5 years. A five year prospective survey on incidence of ovarian enlargement was conducted between 2008 and 2012 in the Obstetric Department of Emergency Clinical County Hospital of Arad. The data obtained from the patient’s study registry and the records from hospitalization were analyzed using Epi Info 7 and GraphPad Software. From the 1566 women that corresponded to inclusion criteria, 313 were found with enlarged ovaries (19.99%). 40 patients (12.78%) needed surgical treatment, 18 during pregnancy and 22 during cesarean section; 18 cystectomies, 11 partial ovarectomies, 5 ovarectomies and 4 adnexectomies were performed. Dermoid cysts, revealed in 21 cases (52.50%), were the most common histopathologic finding. Close follow-up and progesterone supplementation should be the first line of treatment in the management of ovarian pathology associated to pregnancy. Laparoscopy versus open surgery for the surgical treatment of ovarian tumors in pregnancy depends on early detection of enlarged ovaries and appearance of complications; while exteriorizing the uterus in cesarean section is useful for diagnosis and treatment.
Keywords: ovarian cyst, pregnancy, laparoscopy, ultrasonography, cesarean section
References: Alpa M Nick, Kathleen Schmeler, Adnexal Masses in Pregnancy, Perinatology, 2010, 2:13-21
Lee GSR, Hur SY, Shin JC, Kim SP, Kim JS. Elective vs. conservative management of ovarian tumors in pregnancy. Int J Gynaecol Obstet,2004, 85:250–254.Hoffman M, Sayer R, A guide to management: Adnexal masses in pregnancy, OBG Management, 2007, 19(3):27-44
Leiserowitz GS, Managing Ovarian Masses During Pregnancy, Obstetrical and Gynecological Survey, 2006, 61(7):463-470
Leiserowitz GS, Xing G, Cress R, et al. Adnexal masses in pregnancy; how often are they malignant?, Gynecol Oncol. 2006,101:315–321.Volkan Ulker, Ali Gedikbasi, et al, Incidental adnexal masses at cesarean section and review of the literature, J. Obstet. Gynaecol. Res.,2010, 36(3):502-505
Sergent F, Verspyck E, Marpeau L: Management of an ovarian cyst during pregnancy. Presse Med 2003; 32:1039-1045
Mohomed K: Nonmalignant gynecology in James DK, Steer PJ, Weiner CP, et al. High risk pregnancy: Management options, 3rd Edition. Philadelphia, Elsevier Saunders, 2006: 1258-1258
Munkarah AR, Morris RT, Schimp VL: Malignant disease in James DK, Steer PJ, Weiner CP, et al. High risk pregnancy: Management options, 3rd Edition. Philadelphia, Elsevier Saunders, 2006: 1163-1173Whitecar MP, Turner S, Higby MK. Adnexal masses in pregnancy. A review of 130 cases undergoing surgical management. Am J Obstet Gynecol; 1991,181:19–24.
Sherard GB III, Hodson CA, Williams HJ, Semer DA, Hadi HA, Tait DL. Adnexal masses and pregnancy: a 12-year experience. Am J Obstet Gynecol 2003,189:358–362.
Usui R, Minakami H, Kosuge S, et al. A retrospective survey of clinical, pathologic, and prognostic features of adnexal masses operated on during pregnancy. J Obstet Gynaecol Res., 2000,26(2):89–93Zanetta G, Mariani E, Lissoni A, et al, A prospective study of ultrasound in the management of adnexal masses in pregnancy, BJOG, 2003, 110: 578-583
Hermans RHM, Fischer D-C, van der Putten HWHM, et al. Adnexal masses in pregnancy. Onkologie., 2003, 26:167–172
K. Shah, S. Anjurani, V. Ramkumar, P. Bhat, M. Urala: Ovarian Mass In Pregnancy: A Review Of Six Cases Treated With Surgery.The Internet Journal of Gynecology and Obstetrics, 2011,14(2)
Reedy MB, Källén B, Kuehl TJ. Laparoscopy during pregnancy: a study of five fetal outcome parameters with use of the Swedish health registry. Am J Obstet Gynecol., 1997, 177:673–679.
Agarwal N, Parul, Kriplani A, Bhatla N, Gupta A. Management and outcome of pregnancies complicated with adnexal masses. Arch Gynecol Obstet., 2003, 267:148–152.
Schmeler KM, Mayo-Smith WW, Peipert JF, Weitzen S, Manuel MD, Gordinier ME., Adnexal masses in pregnancy: surgery compared with observation. Obstet. Gynecol., 2005, 105:1098–1103
Koonings PP, Platt LD, Wallace R. Incidental adnexal neoplasms at cesarean section. Obstet Gynecol., 1988, 72:767–769
Hess LW, Peaceman A, O’Brien WF, et al, Adnexal mass occurring with intrauterine pregnancy: report of fifty-four patients requiring laparatomy for definitive management, Am J Obstet Gynecol, 1988, 158(5):1029-1034
Carp H, A systematic review of dydrogesterone for the treatment of threatened miscarriage, Gynecologycal Endocrinology, 2012; 28 (12): 983-990.
Tien JC, Tan TY, Non-surgical interventions for threatened and recurrent miscarriages, Singapore Med J, 2007; 48 (12): 1074-1090
Dede M, Yenen MC, Yilmaz U et al, Treatment of incidental adnexal masses at cesarean section: a retrospective study, Int J Gynecol Cancer, 2007, 17:339-341
Dickinson JE. Cesarean Section. In: James DK, Steer PJ, Weiner CP, et al. High risk pregnancy: Management options, 3rd Edition. Philadelphia, Elsevier Saunders, 2006: 1543- 1556 Cunningham FG, Leveno KJ, Bloom SL, et al. Williams Obstetrics, 23rd Edition, New York, McGraw-Hill Medical, 2010: 544-576
Nupur Gupta, Vatsla Dadhwal, et al, Incidental adnexal masses removed at laparoscopic ligation or caesarean section, Arch Gynecol Obstet,2010, 281:775-776
Ingrid Paredes, et all, Incidental adnexal mass at caesarean section- the value of implementing a comprehensive consenting process, BJMP, 2011, 4(1):409
Furau C, Ciobanu G, Craina M, Furau G: Management of adnexal masses during cesarean section- advantages of exteriorizing the uterus technique seen in a twelve year retrospective study in Recent Researches in Medicine and Medical Chemistry, Kos, 2012: 254-258
Balci O, Gezginc K, Karatayli R, Acar A, Celik C, Colakoglu MC, Management and outcomes of adnexal masses during pregnancy: a 6-year experience. J Obstet Gynaecol, 2008 34:524–528
Turki Gasim, Sana A. Al Dakhiel, Ahlam A. Al Ghamdi, Mariam Al Ali, Fathia Al Jama, Jessica Rahman, Suleiman A. Al Suleiman, Mohammad S. Rahman (2010) Ovarian tumors associated with pregnancy: a 20-year experience in a teaching hospital, Arch Gynecol Obstet 282:529–533
Lisa Katz, Amalia Levy, Arnon Wiznitzer, Eyal Sheiner, Pregnancy outcome of patients with dermoid and other benign ovarian cysts, Arch Gynecol Obstet, 2010; 281:811–815
Adamson David, Martin Daniel- Endocopic Management of Gynecologic Disease, Editura Lippincott-Raven Publishers Philadelphia, New York 1996
Craina M, Anastasiu D., Furau Gh., Gluhovschi A., Nitu R.- Laparoscopic Cystectomy During Pregnancy, Bari 2008
Read_full_article: pdf/vol18/iss3/1 JMA 2015 - Furau - Management of enlarged.pdf
Correspondence: MD Furău Cristian,
No 109, Clujului Street, Arad, Arad County, PO: 310057; Tel: + 40 722 981 369
Email: This e-mail address is being protected from spambots. You need JavaScript enabled to view it
Read full article
Article Title: MANAGEMENT OPTIONS FOR ENLARGED OVARIES DETECTED IN THE FIRST TRIMESTER OF PREGNANCY
Authors: FURĂU Cristian1,2, FURĂU Gheorghe1,2,TATARU Ana Liana1,2, ONEL Cristina1,2, STĂNESCU Casiana1,2 , CRAINA Marius3,4, DIMITRIU Mihai5
Affiliation: 1 Western University „Vasile Goldis” of Arad
2 Obstetrics and Gynecology Department of the Emergency Clinical County Hospital of Arad
3 „Victor Babes” University of Medicine and Pharmacy Timisoara
4 Bega Clinic for Obstetrics and Gynecology Timisoara
5”Carol Davila” University of Medicine and Pharmacy Bucharest, Obstetrics and Gynecology Department
Abstract: Ovarian cysts have a reported incidence in pregnancy between 1:81 and 1:2500. The development of ultrasound in the first trimester of pregnancy revealed a much higher incidence and although complications are not very frequent, early diagnosis of ovarian cysts is very important for their management. To analyze the incidence and possibilities of management for first trimester enlarged ovaries in pregnancy in Arad County for a period of 5 years. A five year prospective survey on incidence of ovarian enlargement was conducted between 2008 and 2012 in the Obstetric Department of Emergency Clinical County Hospital of Arad. The data obtained from the patient’s study registry and the records from hospitalization were analyzed using Epi Info 7 and GraphPad Software. From the 1566 women that corresponded to inclusion criteria, 313 were found with enlarged ovaries (19.99%). 40 patients (12.78%) needed surgical treatment, 18 during pregnancy and 22 during cesarean section; 18 cystectomies, 11 partial ovarectomies, 5 ovarectomies and 4 adnexectomies were performed. Dermoid cysts, revealed in 21 cases (52.50%), were the most common histopathologic finding. Close follow-up and progesterone supplementation should be the first line of treatment in the management of ovarian pathology associated to pregnancy. Laparoscopy versus open surgery for the surgical treatment of ovarian tumors in pregnancy depends on early detection of enlarged ovaries and appearance of complications; while exteriorizing the uterus in cesarean section is useful for diagnosis and treatment.
Keywords: ovarian cyst, pregnancy, laparoscopy, ultrasonography, cesarean section
References: Alpa M Nick, Kathleen Schmeler, Adnexal Masses in Pregnancy, Perinatology, 2010, 2:13-21
Lee GSR, Hur SY, Shin JC, Kim SP, Kim JS. Elective vs. conservative management of ovarian tumors in pregnancy. Int J Gynaecol Obstet,2004, 85:250–254.Hoffman M, Sayer R, A guide to management: Adnexal masses in pregnancy, OBG Management, 2007, 19(3):27-44
Leiserowitz GS, Managing Ovarian Masses During Pregnancy, Obstetrical and Gynecological Survey, 2006, 61(7):463-470
Leiserowitz GS, Xing G, Cress R, et al. Adnexal masses in pregnancy; how often are they malignant?, Gynecol Oncol. 2006,101:315–321.Volkan Ulker, Ali Gedikbasi, et al, Incidental adnexal masses at cesarean section and review of the literature, J. Obstet. Gynaecol. Res.,2010, 36(3):502-505
Sergent F, Verspyck E, Marpeau L: Management of an ovarian cyst during pregnancy. Presse Med 2003; 32:1039-1045
Mohomed K: Nonmalignant gynecology in James DK, Steer PJ, Weiner CP, et al. High risk pregnancy: Management options, 3rd Edition. Philadelphia, Elsevier Saunders, 2006: 1258-1258
Munkarah AR, Morris RT, Schimp VL: Malignant disease in James DK, Steer PJ, Weiner CP, et al. High risk pregnancy: Management options, 3rd Edition. Philadelphia, Elsevier Saunders, 2006: 1163-1173Whitecar MP, Turner S, Higby MK. Adnexal masses in pregnancy. A review of 130 cases undergoing surgical management. Am J Obstet Gynecol; 1991,181:19–24.
Sherard GB III, Hodson CA, Williams HJ, Semer DA, Hadi HA, Tait DL. Adnexal masses and pregnancy: a 12-year experience. Am J Obstet Gynecol 2003,189:358–362.
Usui R, Minakami H, Kosuge S, et al. A retrospective survey of clinical, pathologic, and prognostic features of adnexal masses operated on during pregnancy. J Obstet Gynaecol Res., 2000,26(2):89–93Zanetta G, Mariani E, Lissoni A, et al, A prospective study of ultrasound in the management of adnexal masses in pregnancy, BJOG, 2003, 110: 578-583
Hermans RHM, Fischer D-C, van der Putten HWHM, et al. Adnexal masses in pregnancy. Onkologie., 2003, 26:167–172
K. Shah, S. Anjurani, V. Ramkumar, P. Bhat, M. Urala: Ovarian Mass In Pregnancy: A Review Of Six Cases Treated With Surgery.The Internet Journal of Gynecology and Obstetrics, 2011,14(2)
Reedy MB, Källén B, Kuehl TJ. Laparoscopy during pregnancy: a study of five fetal outcome parameters with use of the Swedish health registry. Am J Obstet Gynecol., 1997, 177:673–679.
Agarwal N, Parul, Kriplani A, Bhatla N, Gupta A. Management and outcome of pregnancies complicated with adnexal masses. Arch Gynecol Obstet., 2003, 267:148–152.
Schmeler KM, Mayo-Smith WW, Peipert JF, Weitzen S, Manuel MD, Gordinier ME., Adnexal masses in pregnancy: surgery compared with observation. Obstet. Gynecol., 2005, 105:1098–1103
Koonings PP, Platt LD, Wallace R. Incidental adnexal neoplasms at cesarean section. Obstet Gynecol., 1988, 72:767–769
Hess LW, Peaceman A, O’Brien WF, et al, Adnexal mass occurring with intrauterine pregnancy: report of fifty-four patients requiring laparatomy for definitive management, Am J Obstet Gynecol, 1988, 158(5):1029-1034
Carp H, A systematic review of dydrogesterone for the treatment of threatened miscarriage, Gynecologycal Endocrinology, 2012; 28 (12): 983-990.
Tien JC, Tan TY, Non-surgical interventions for threatened and recurrent miscarriages, Singapore Med J, 2007; 48 (12): 1074-1090
Dede M, Yenen MC, Yilmaz U et al, Treatment of incidental adnexal masses at cesarean section: a retrospective study, Int J Gynecol Cancer, 2007, 17:339-341
Dickinson JE. Cesarean Section. In: James DK, Steer PJ, Weiner CP, et al. High risk pregnancy: Management options, 3rd Edition. Philadelphia, Elsevier Saunders, 2006: 1543- 1556 Cunningham FG, Leveno KJ, Bloom SL, et al. Williams Obstetrics, 23rd Edition, New York, McGraw-Hill Medical, 2010: 544-576
Nupur Gupta, Vatsla Dadhwal, et al, Incidental adnexal masses removed at laparoscopic ligation or caesarean section, Arch Gynecol Obstet,2010, 281:775-776
Ingrid Paredes, et all, Incidental adnexal mass at caesarean section- the value of implementing a comprehensive consenting process, BJMP, 2011, 4(1):409
Furau C, Ciobanu G, Craina M, Furau G: Management of adnexal masses during cesarean section- advantages of exteriorizing the uterus technique seen in a twelve year retrospective study in Recent Researches in Medicine and Medical Chemistry, Kos, 2012: 254-258
Balci O, Gezginc K, Karatayli R, Acar A, Celik C, Colakoglu MC, Management and outcomes of adnexal masses during pregnancy: a 6-year experience. J Obstet Gynaecol, 2008 34:524–528
Turki Gasim, Sana A. Al Dakhiel, Ahlam A. Al Ghamdi, Mariam Al Ali, Fathia Al Jama, Jessica Rahman, Suleiman A. Al Suleiman, Mohammad S. Rahman (2010) Ovarian tumors associated with pregnancy: a 20-year experience in a teaching hospital, Arch Gynecol Obstet 282:529–533
Lisa Katz, Amalia Levy, Arnon Wiznitzer, Eyal Sheiner, Pregnancy outcome of patients with dermoid and other benign ovarian cysts, Arch Gynecol Obstet, 2010; 281:811–815
Adamson David, Martin Daniel- Endocopic Management of Gynecologic Disease, Editura Lippincott-Raven Publishers Philadelphia, New York 1996
Craina M, Anastasiu D., Furau Gh., Gluhovschi A., Nitu R.- Laparoscopic Cystectomy During Pregnancy, Bari 2008
*Correspondence: MD Furău Cristian,
No 109, Clujului Street, Arad, Arad County, PO: 310057; Tel: + 40 722 981 369
Email: This e-mail address is being protected from spambots. You need JavaScript enabled to view it