Surgical management of benign ovarian tumors in pregnancy
Aim. To improve diagnosis and treatment outcomes of benign ovarian tumors (BOT) in pregnancy.Barinov S.V., Gachkailo I.А., Lazareva О.V., Shkabarnya L.L.
Materials and methods. The study comprised 62 pregnant patients who underwent laparoscopic (n = 47) and laparotomic (n = 15) surgery for BOT. A between-group comparative analysis of clinical data was conducted.
Results. Morphological types of BOT included teratoma (6/17), mucinous cystadenoma (1/17), simple serous cyst (5/17), follicular cyst (3/17), and endometriosis (2/17). The study findings showed a significant increase in the size of BOTs during pregnancy (p = 0.0003). Laparoscopic access was associated with less blood loss (p = 0.0003) and pain (p = 0.001), which helped avoid postoperative narcotic analgesics; hospital stay was shorter (p = 0.04).
Conclusion. Early diagnosis and treatment of BOT allow prolongation of pregnancy to the full-term birth with the prevention of pregnancy complications.
Keywords
pregnancy
benign ovarian tumors
laparoscopy
laparotomy
ovarian cancer
References
- Баринов С.В., Корнеев Б.В., Гребенюк М.В. и др. К вопросу об оперативном лечении доброкачественных новообразований яичников при беременности. Журнал акушерства и женских болезней. 2015; 64 (4): 13–20. [Barinov S.V., Lazareva O.V., Korneev B.V., Shkabarnya L.L., Grebenuk M.V., Roshchupkina E.A., Belokopytova A.V., Sorokin P.I.to the matter about operational treatment of benign neoplasms of ovaries during pregnancy. Zhurnal akusherstva i zhenskikh bolezney/Journal of obstetrics and women’s diseases. 2015; 64(4): 13–20. (in Russian)]. https://doi.org/10.17816/JOWD64413-20
- Mukhopadhyay A., Shinde A., Naik R. Ovarian cysts and cancer in pregnancy. Best Pract Res Clin Obstet Gynaecol. 2016; 33: 58–72. doi: 10.1016/j.bpobgyn.2015.10.015
- Ye P., Zhao N., Shu J., et al. Laparoscopy versus open surgery for adnexal masses in pregnancy: a meta-analytic review. Arc Gynecol Obstet. 2019; 299(3): 625–34. doi: 10.1007/s00404-018-05039-y
- Zagouri F., Dimitrakakis C., Marinopoulos S. et al. Cancer in pregnancy disentangling treatment modalitities. ESMO Open. 2016; 1(3): e000016. doi: 10.1136/esmoopen-2015-000016
- De Haan J., Verheecke M., Amant F. Management of ovarian cysts and cancer in pregnancy. Facts Views Vis Obgyn. 2015; 7(1): 25-31. PMCID: PMC4402440
- Соломатина А.А., Кавтеладзе Е.В. Опухоли и опухолевидные образования яичников при беременности. Акушерство и гинекология: новости, мнения, обучение. [Solomatina A.A., Kavteladze E.V. Tumors and ovarian masses at pregnancy. Akusherstvo i ginekologiya: novosti, mneniya, obucheniye. 2017; 1(15): 89–97. (in Russian)]. doi: 10.24411/2303-9698-2017-00023
- Герасимова А.А., Швырев С.Л., Шевченко Ю.В., Гус А.И., Клименко П.А. Характеристика ультразвуковых критериев образований придатков матки у беременных. Вестник РГМУ. 2013; 1: 35–40. [Gerasimova A.A., Shvyrev S.L., Shevchenko Yu.V., Gus A.I., KIimenko P.A. Ultrasaund Criterias of Benign Ovarian Tumors during the Pregnancy. Vestnik RGMU/ Herald of the RSMU. 2013; 1: 35–40. (in Russian)]. eLIBRARY ID: 24329448
- Урманчеева А.Ф., Кутушева Г.Ф., Ульрих Е.А. Опухоли яичника (клиника, диагностика и лечение). СПб.: ООО «Изд-во Н-Л», 2012. 43 с. [Urmancheeva A.F., Kutusheva G.F., Ulrich E.A. Ovarian tumors (clinic, diagnosis and treatment). SPb.: LLC Publishing House NL, 2012. 43 p. (in Russian)].
- Чекини Д.А., Трякин А.А., Федянин М.Ю., Тюляндин С.А. Злокачественные герминогенные опухоли яичников: эпидемиология, клиника, диагностика, лечение. Вестник РОНЦ им. Н.Н. Блохина. 2016; 2: 39–46. [Chekiny D.A., Tryakin A.A., Fedyanin M.Y., Tulyandin S.A. Malignant ovarian germ cell tumors: epidemiology, clinical features, diagnosis, treatmentabstract. Vestnik RONTS im. N. N. Blokhina/Bulletin of the Russian Research Center N. N. Blokhin. 2016; 2: 39–46. (in Russian)].
- Lu J., Zheng Zh., Zhang Q., et. al. Measurement of HE4 and CA125 and establishment of reference intervals for the ROMA index in the sera of pregnant women. 2018; 32(5): e22368. doi: 10.1002/jcla.22368
- Ball E., Waters N., Cooper N., et al. Evidence-Based Guideline on Laporoscopy in Pregnancy. Commissioned by the British Society for Gynaecological Endoscopy (BSGE). Royal Coll Obst Gynaecol (RCOG). 2019; 11(1): 5–25.
- Fauvet R., Brzakowski M., Morice P. et al. Borderline ovarian tumors diagnosed during pregnancy exhibit a high incidence of aggressive features: results of a French multicenter study. An Oncol. 2012; 23(6): 1481–7. https://doi.org/10.1093/annonc/mdr452
- Fan-Hlan Koo, Kuan-Chin Wang, et al. An 11-year experience with ovarian surgery during pregnancy. J Chin Med Associat. 2013; 76: 452–7. http://
- dx.doi.org/10.1016/j.jcma.2013.04.008
- Ngu S.F., Cheung V.Y., Pun T.C. Surgical management of adnexal masses in pregnancy. JSLS. 2014; 18:71–5. doi: 10.4293/108680813X13693422521007.
- Мартынов С.А., Жорданиа К.И., Адамян Л.В., Данилов А.Ю. Особенности диагностики и хирургического лечения беременных с опухолями и опухолевидными образованиями яичников. Онкогинекология. 2014; 2: 27–32. [Martynov S.A., Zhordania K.I., Adamyan L.V., Danilov A.Yu. Particularities of the diagnosis and surgical treatment for pregnant patients with ovarian tumors and tumor-like lesions of the ovaries. Onkoginekologiya. 2014; 2: 27–32. (in Russian)]. eLIBRARY ID: 22590401
Received 19.12.2019
Accepted 26.12.2019
About the Authors
Sergey V. Barinov, MD, Professor, Head of the Department of Obstetrics and Gynecology №2. State Educational Institution of Higher Professional Education “Omsk State Medical University” Ministry of Health of the Russian FederationTel.: +73812240658. E-mail: barinov_omsk@mail.ru. ORCID: 0000-0002-0357-70977.644099, Russia, Omsk, Lenina str. 12.
Ivan A. Gachkaylo, 1-year clinical intern of obstetrics and gynecology №2. State Educational Institution of Higher Professional Education “Omsk State Medical University” Ministry of Health of the Russian Federation. Tel.: +79136543400. E-mail: vanes_00@mail.ru
644099, Russia, Omsk, Lenina str., 12.
Oksana Vy. Lazareva, PhD, associate Professor of the Department of Obstetrics and Gynecology №2. State Educational Institution of Higher Professional Education
“Omsk state medical University” Ministry of Health of the Russian Federation. Tel.: +79045846699. E-mail: lazow@mail.ru. ORCID: 0000-0002-0895-4066.
644099, Russia, Omsk, Lenina str. 12.
Lyudmila L. Shkabarnya, head of the gynecology department. Affordable Health Care Institution of Omsk Region “Regional Hospital”. Tel.: +73812251578.
E-mail: l_shka@mail.ru. ORCID: 0000-0001-6080-1828.
644111, Russia, Omsk, Berezovaya str., 3.
For citation: Barinov S.V., Gachkailo I.А., Lazareva О.V., Shkabarnya L.L. Surgical management of benign ovarian tumors in pregnancy.
Akusherstvo i Ginekologiya/Obstetrics and Gynecology. 2020; 1(Suppl):50-5. (in Russian)
https://dx.doi.org/10.18565/aig.2020.1suppl.50-55
Similar Articles
