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Ovarian cysts and cancer in pregnancy

Lookup NU author(s): Dr Asima Mukhopadhyay

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Abstract

Adnexal masses are diagnosed in 5% pregnancies and pose diagnostic and management challenges. Ultrasound and magnetic resonance imaging (MRI) are the mainstay as an evaluation procedure; surgery is warranted for persistent masses with a diameter of >5 cm and sonographic signs of possible malignancy. Optimal timing for a planned surgery is the second trimester and does not adversely affect neonatal outcome. Laparoscopy is safe in pregnancy. Management for ovarian cancer during pregnancy should be individualised and formulated by a multidisciplinary team in a specialised centre while also considering the patients' wishes to preserve pregnancy. The following options can be considered: (i) induced abortion followed by standard management of ovarian cancer, (ii) pregnancy-preserving surgery followed by chemotherapy, planned delivery and secondary surgical completion or (iii) neoadjuvant chemotherapy followed by surgery during the postpartum period. Standard chemotherapy administered in nonpregnant population can only be used during the first trimester of pregnancy. (C) 2015 Elsevier Ltd. All rights reserved.

Publication metadata

Author(s): Mukhopadhyay A, Shinde A, Naik R

Publication type: Article

Publication status: Published

Journal: Best Practice & Research Clinical Obstetrics & Gynaecology

Year: 2016

Volume: 33

Pages: 58-72

Print publication date: 01/05/2016

Online publication date: 30/10/2015

Acceptance date: 01/01/1900

ISSN (print): 1521-6934

ISSN (electronic): 1532-1932

Publisher: Elsevier

URL: http://dx.doi.org/10.1016/j.bpobgyn.2015.10.015

DOI: 10.1016/j.bpobgyn.2015.10.015

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