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
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*Correspondence:	MD Furău Cristian, No 109, Clujului Street, Arad, Arad County, PO: 310057; Tel: + 40 722 981 369 Email: cristianfurau@gmail.com