Management of incidental adnexal masses on caesarean section

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Date: July-September 2012
From: Nigerian Medical Journal(Vol. 53, Issue 3)
Publisher: Medknow Publications and Media Pvt. Ltd.
Document Type: Medical condition overview
Length: 1,922 words
Lexile Measure: 1580L

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Byline: Huseyin. Cengiz, Cihan. Kaya, Murat. Ekin, Ali. Yesil, Levent. Yasar

Background: The reported incidence of adnexal masses during pregnancy vary from 1 in 81 pregnancies to 1 in 8000 pregnancies. There is still a debate on management of incidental adnexal masses during the caesarean section concerning the risk of this additional procedure on postoperative morbidity and mortality. The aim of our study was to investigate the management of incidental adnexal masses which were observed during caesarean section in a tertiary health care centre. Materials and Methods: The medical records of the patients who had incidental adnexal masses during caesarean section at Bakirkoy Dr. Sadi Konuk Teaching and Research Hospital, Department of Obstetrics and Gynecology from January 2006 to September 2011 were evaluated retrospectively. The data was processed with the SPSS 16.0 statistical software. Results: The number of total live births was 17341 and 6624 of them were done by caesarean section (31%). There were 38 cases of incidental adnexal masses which were discovered at caesarean section. The most common pathologic diagnosis of the masses were paraovarian-paratubal cysts with the rate of 23.7% (n=9). Cystectomy procedure during caesarean section did not alter the morbidity of the patient. Conclusions: In conclusion for detecting adnexal masses during pregnancy follow-up of growth rate of adnexal mass will be a useful reference during the observation period if ideally all pregnant women have a first-trimester ultrasound examination with regular adnexa check-up.

Introduction

The reported incidence of adnexal masses during pregnancy vary from 1 in 81 pregnancies to 1 in 8000 pregnancies. [sup][1] This large variation is due to methods of detection, differences in the definition of clinically significant masses and delivering adequate health care to pregnant population. The incidence has been steadily increasing due to the widespread use of ultrasound, other imaging techniques and increasing rates of caesarean deliveries. Although most of the adnexal masses are pregnancy related and may resolve by the 16 [sup]th week of gestation, the management of the masses that persist is still controversial. [sup][2] There is still a debate on management of incidental adnexal masses during the caesarean section concerning the risk of this additional procedure on postoperative morbidity and mortality. The aim of our study was to investigate the management of incidental adnexal masses which were observed during caesarean section in a tertiary health care centre.

Materials and Methods

The medical records of the patients who had incidental adnexal masses during caesarean section at Bakirkoy Dr. Sadi Konuk Education and Research Hospital, Department of Obstetrics and Gynecology from January 2006 to September 2011 were evaluated retrospectively. The ethics committee approval obtained by the local ethics committee. The data was collected from inquiry forms, operation records, pathology records and laboratory findings. Maternal age, gravidity, parity, caesarean indication, pre- and post-operative complete blood count, duration of hospitalization, intraoperative and pathological findings. Patients with adnexal masses identified preoperatively were excluded from the...

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Gale Document Number: GALE|A312129305