MANAGEMENT OF OVARIAN MASSES DURING PREGNANCY

Andrei Manu; C. B. Coroleucă; C. A. Coroleucă; D. Comandașu; D. Mihai; M. Mitran; E. Brătilă

doi:10.33695/jss.v5i3.234

Andrei Manu University of Medicine and Pharmacy “Carol Davila” Bucharest, Romania
C. B. Coroleucă Clinical Hospital of Obstetrics and Gynecology “Prof. Dr. Panait Sârbu”
C. A. Coroleucă The University of Medicine and Pharmacy “Carol Davila”, Bucharest, Romania; Clinical Hospital of Obstetrics and Gynecology “Prof. Dr. Panait Sârbu”
D. Comandașu The University of Medicine and Pharmacy “Carol Davila”, Bucharest, Romania; Clinical Hospital of Obstetrics and Gynecology “Prof. Dr. Panait Sârbu”
D. Mihai University of Medicine and Pharmacy “Carol Davila” Bucharest, Romania
M. Mitran Clinical Hospital of Obstetrics and Gynecology “Prof. Dr. Panait Sârbu”
E. Brătilă The University of Medicine and Pharmacy “Carol Davila”, Bucharest, Romania; Clinical Hospital of Obstetrics and Gynecology “Prof. Dr. Panait Sârbu”

DOI: https://doi.org/10.33695/jss.v5i3.234

Keywords: ovarian mass, pregnancy, ultrasound, laparotomy, laparoscopy, robotic surgery

Abstract

The purpose of this paper is to present the therapeutic conduct regarding the diagnosis, prognosis
and management (surgical or conservatory) of the ovarian masses during pregnancy. In this paper
we will present the imagistic ways of diagnosis and the surgical therapeutic options (laparotomy,
laparoscopy, robotic surgery) according to the characteristic of masses. We included 19 articles
that researched the therapeutic conduct of ovarian masses during pregnancy. Transvaginal
ultrasound is the first-line method of choice in the differential diagnosis of the ovarian masses.
Evaluation of the ovarian masses during pregnancy must be done by a trained operator in order to
choose the optimal therapeutic conduct. In the case of ovarian tumors with ultrasound benign
ultrasound characteristics it is recommended the use of a therapeutic conservatory approach. The
therapeutic conduct should be adapted individually for each patient. Decision criteria for the
surgical approach (laparotomy or laparoscopy) must consider the measurements of the mass, the
gestational age, ultrasound characteristics and surgical experience. The multidisciplinary
approach is recommended in the management of this patients especially when there is a malignancy
suspicion. The advantages of robotic surgery in these situations are represented by the high quality
imaging, reduced uterine manipulation, precise dissection and a low rate of conversion to
laparotomy.