Laparoscopic management of ovarian masses during pregnancy

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Monia Malek-mellouli
Najeh Taamallah
Fethi Ben Amara
Hédi Reziga

Abstract

Background: The diagnosis of an adnexal mass associated with pregnancy is increasingly common with the routine use of ultrasound during prenatal care.
aim: To assess the feasibility, advantages and limiting factors of laparoscopy in the management of ovarian masses during pregnancy.
methods: Rretrospective study of a series of 34 pregnant women operated by laparoscopy for adnexal masses during a period of 14 years.
results: The mean age of patients was 29 years. Fifty percent of patients were nulliparous. In 62% of cases, patients were asymptomatic. Laparoscopy was performed at a mean gestational age of 15 weeks. Open laparoscopy was performed in 58.8% of cases. Intraperitoneal cystectomy was performed in 28 cases (72%). In two cases (5 %), it was a borderline ovarian tumor requiring further surgery outside of pregnancy. Fetal loss was noted at a term of 16 weeks.
Conclusion: Laparoscopic management of adnexal masses during pregnancy appears to be safe and reproducible procedure with few maternal and fetal complications.

Keywords:

Adnexal mass; pregnancy; laparoscopy.

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