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Management of adnexal masses in pregnancy

Consultant in Obstetrics and Gynaecology, St John's Hospital, Wood Street, Chelmsford, CM2 9BG, UK E-mail: cpspencer{at}doctors.org.uk (corresponding author)

Phil J Robarts, FRCOG

Consultant in Obstetrics and Gynaecology, St John's Hospital, Chelmsford, UK

Asymptomatic adnexal masses are frequently diagnosed in pregnancy, either at the early booking scan or at the time of caesarean section. They are mostly ovarian in origin. In this article we discuss the role of magnetic resonance imaging, computed tomography, Doppler studies and the use of tumour markers in diagnosis. The majority of ovarian cysts in pregnancy either resolve spontaneously or are due to benign conditions. Ovarian cancer is extremely rare in women of childbearing age and thus most of these cysts can be managed conservatively. If there is a suspicion of malignancy or there is a significant cyst complication, such as torsion, and surgery is planned, this should take place during the second trimester to minimise the risk of miscarriage.

Keywords adnexal masses / magnetic resonance imaging / ovarian cancer / ovarian cysts / pregnancy / ultrasonography