Evaluation and Management of Suspicious Adnexal Masses in Pregnancy- A Retrospective Study

Introduction: The incidence of suspicious ovarian masses in pregnancy is on the rise due to the increased use of ultrasonography in recent times. However little is known about their management during pregnancy due to the lack of large randomised trials.

Aim: To evaluate the incidence, nature and management of suspicious adnexal masses diagnosed during pregnancy at our institution.

Materials and Methods: This was a retrospective study of 33 pregnant women who presented with suspicious ovarian masses at the Department of Gynaec Oncology at the Institute of Obstetrics and Gynaecology, Madras Medical College, Chennai, Tamil Nadu, India, from August 2018 to September 2020. Patients were evaluated with imaging studies as per the International Ovarian Tumour Analysis (IOTA) ultrasound rules along with Magnetic Resonance Imaging (MRI) and tumour markers and surgical intervention were performed for cases with definite indications. The Statistical Package for Social Science (SPSS) version 28.0 was used for statistical analysis.

Results: Mean age of the patients was 26.1±2.1 years (20-33 years). Most common gestational age of presentation was the 2nd trimester of pregnancy (mean-18.9 weeks). Out of 33 patients, 27 were benign (81.82%) and 6 (18.18%) malignant. Surgical intervention was done for 18 cases (54.55%) and 15 (45.45%) patients were kept under observation. Five were primary ovarian and one was metastatic from carcinoma stomach.

Conclusion: Thorough clinical evaluation with personalised imaging and appropriate timely intervention aid in the diagnosis and management of suspicious adnexal masses in pregnancy.