| Objective To discuss diagnosis,pathology,treatment and the outcomes of pregnancy with ovarian tumor.Methods A retrospective research of 206 cases of patients with ovarian tumorand which were diagnosed by surgery and pathology at Qilu Hospital of Shandong University from Janauary 2011 to september 2016,statistically analyzing the clinical characteristics,preliminary diagnostic mode,operation time and surgical options,pathological pattern,outcomes of pregnancy.Results Among the 206 cases,16 cases(16/206 7.77%)were examined before pregnancy,of which 3 cases were detected by pelvic examination,13 cases were found by ultrasonography;68 cases(68/206 33.01%)were detected before 14 weeks’pregancy,6 cases were found by physical examination,62 cases were detected by ultrasonic examination;18 cases(18/206 8.74%)were found during 14 to 28 weeks,pregnancy,among which 17 cases were figured out by ultrasonography,only 1 case was detected by pelvic examination;34 cases(34/206 16.50%)were found after 28 weeks’ pregnancy by ultrasonic examination;the rest 70 cases(70/206 33.98%)were first discovered during the caesarean section.58 cases(42.65%58/136)underwent surgeries during pregnancy:20 cases(14.71%,20/136)were before 14 weeks’pregnancy,among which 10 patients were given induced abortion;37 cases(16.50%34/136)were between 14 to 28 weeks’ pregnancy,1 case of which firstly underwent the operation of ovarian tumor removal,then underwent the ovarain cancer staging surgery two weeks later because of the ovarian cancer conventional pathological diagnosis.1 case(0.74%,1/136)was in the third semester which underwent palliative surgery combined with therapeutic caesarean section beucause of metastatic bilateral ovarian tumor.A total of 9 cases(4.37%9/206)were confirmed having happened complications by surgery,of which 7 cases(3.40%7/206)combined with pedicle torsion of ovarian tumors,2 cases(0.97%2/206)combined with rupture of ovarian tumor.There were 10 patients having undergone operations before 14 weeks’pregnancy,of which 9 cases delivered at term,none happened spontaneous abortion.37 patients underwent operations during 14 to 28 weeks’ pregnancy,among which 33 cases delivered at term,1 case delivered preterm because of tumor recurrence.Among all the pathological types,193 cases(93.69%193/206)are benign ovarian tumor,among which the common types are mature teratoma(45.15%93/206),endometrial implantation cyst(16.50%34/206),mucinous cystadenoma(16.99%35/206),serous cystadenoma(6.31%13/206).8 cases(3.88%8/206)are malignant tumor,among which 5 cases are mucinous cystadenocarcinoma,1 case is serous cystadenocarcinoma,1 case is immature teratoma,1 case is metastatic ovarian tumor.5 cases are borderline ovarian tumor,of which 3 cases(1.46%)are borderline serous cystadenoma,2 cases(0.97%)are borderline mucinous cystadenoma,1 case is borderline endometrioid tumor.Conclusion Normative gynaecological check-up and ultrasonography during the early and middle period of pregnancy is helpful to diagnosis,but for small tumor,detection and judgment of benign or malignant tumors have certain limitations.Careful examination of double appendix in cesarean section is also of great importance.Gestational weeks,judgment of benign or malignant ovarian lesions,age,pregnancy willing are the main factors influencing the clinical decision.Most of the ovarian benign lesions can undergo expectant treatment to terminate pregnancy,mother and fetus ending are often satisfying.Cases which combined with symptoms,complications or highly suspected with malignant tumor need timely operations. |
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