Maternal and Fetal Outcome of Pregnancies Complicated by Ovarian Tumor

Abstract

Introduction:  Ovarian tumors when occur, endanger two lives, mother and that of fetus. It becomes a therapeutic challenge to evaluate the necessity of immediate intervention for maternal indication versus delaying therapy for fetal indication.¹ Majority of these cysts are benign and usually are functional cysts, dermoid or cystadenomas.² 2-5%of adnexal masses during pregnancy are true malignant neoplasms.³ Ovarian cancer being the second most frequent gynaecological cancer compli-cating pregnancy has an average estimated incidence of 1 in 2500 deliveries.⁴ Keeping in view all that, a study was conducted in Fatima Memorial Hospital to see maternal and fetal outcome of pregnancies complicated by ovarian tumors.

Objective:  To determine the maternal and fetal outcome of pregnancies complicated by ovarian tumors.

Study Design:  Case series descriptive study.

Setting:  The study was conducted in obstetrics and gynaecology department of Fatima Memorial Hospital, Lahore.

Duration of Study:  This study was conducted for one year.

Subjects and Method:  All 14500 pregnant ladies, who visited antenatal clinic and emergency of Fatima Memorial Hospital Lahore for one year, were considered to sort out pregnancies complicated by a co-existent ovarian mass of > 5 cm.

Results:  Of all 36 patients, included in current study, 24 had surgical and 12 had conservative management. Obstetric out-come revealed one preterm delivery after conservative management. Surgical intervention resulted in two abortions, two pre-term and twenty term deliveries. In both groups, the ratio of abdominal and vaginal delivery was 1:2 respectively. Fetal outcome revealed only one preterm and one IUGR infant in conservative group while surgically managed group revealed two preterm infants, two IUGR and one infant with septicemia.

Conclusion:  Surgical intervention is a reasonable approach to deal with cases of ovarian tumors with pregnancy, but con-servative management may also have comparable obstetric outcome provided the selection criteria for patient is, asympto-matic ovarian mass of less than 8cm that is not suspected of malignancy.

Key Words:  Ovarian tumors, Pregnancy, Neoplasm, Cyst, Cancer, Septicemia.