A Clinical Study on the Ovarian Tumors in Pregnancy

Choi, Y M; Kim, B C; Kim, J H; Suh, S S

Abstract

The fifty three cases of ovarian tumors in pregnancy among 27,466 deliveries seen at Department of Obstetrics AND Gynecology, Presbyterian Medical Center ; from January 1st, 1990 to December 30th, 1995, were clinically observed and statistically reviewed. The diagnosis of ovarian tumor was confirmed by pathologist after operation(laparotomy). The results obtained were as follows : 1) The incidence of benign ovarian tumors in pregnancy was 1 in 518 deliveries. The incidence of malignant tumor in pregnancy were 2 in 27,446 deliveries and the one case was endometrioid cancer, the other case was Krukenberg tumor. 2) Mean age was 24yrs old and the range was 18~33 yrs old. Mean parity was 0.4. 3) As to the initial chief complaints or the mode of presentation, no symptoms and signs were in 31 cases(59.1 %) low abdominal pain in 12 cases(22.7 %) was found in 12 cases(22.7 %), palpable mass were 10 cases(18.2 %). 4) As to the timing of diagnosis, 27.3 % was diagnosed in the 1st trimester, 68.1 % in the 2nd trimester, 4.5 % in the 3rd trimester. 5) According to the method of diagnosis, known ovarian tumors were 17 cases(31.8 %), 31 cases(59.1 %) were found by physical examination and ultrasonography and 5 cases(9.1 %) were incidental finding during cesarean section. 6) As to the size of tumor, 2 cases(4.5 %) were less than 6 cm in diameter, 34 cases(63.6 %) were 7~10 cm, 7 cases(13.6 %) were 11~15 cm, and 10 cases(18.3 %) were over 16 cm. 7) According to the type of operation, unilateral oophorectomy was performed in 29 cases(54.7 %), unilateral salpingoophorectomy in 13 cases(24.5 %), unilateral cystectomy in 4 cases(7.5 %), unilateral ovarian wedge resection in 5 cases(9.4 %), bilateral right oophorectomy with left ovarian wedge resection in 2 cases(3.9 %). 8) According to the histopathologic type, there were 22 cases(41.5 %) of cystic teratoma, 11 cases(20.8 %) of simple cyst(9.4 %) of serous cystadenoma, 6 cases(11.3 %) of corpus luteal cyst, 5 cases(9.4 %) of mucinous cystadenoma, 2 cases(3.8 %) of endometrial cyst., one case(1.9 %) of Krukenberg tumor and endometriod cancer, respectively. 9) As to incidental of complications resulting from ovarian tumors 15 cases(28.3 %), being 10 cases(18.9 %) of torsion, 4 cases(7.5 %) of rupture, 1 case(1.9 %) of mechanical obstrution. 10) Among the reviewed cases, 51 cases(96.1 %) were unilateral and 2 cases(3.9 %) were bilateral. 11) According to outcome of pregnancies and mode of deliveries, 48 cases(90.25) were followed up. Among them, term delivery in 44 cases(81.6%), among them, vaginal delivery in 42 cases, cesarean section in 2 cases(2.4%) and spontaneous abortion in 3 cases(6.2%) and artificial abbortion in 1 case(2.4%) were occurred. 5 cases(9.8%) were not followed up.