Department of Obstetrics and Gynecology, Taipei Veterans General Hospital, Taipei, Taiwan, ROC.
J Chin Med Assoc. 2013 Aug;76(8):452-7. doi: 10.1016/j.jcma.2013.04.008. Epub 2013 Jun 6.
The management of ovarian tumors during pregnancy can be challenging because of the risk of fetal wastage and the possibility of surgery-related complications, or a delayed diagnosis of a possibly lethal disease or malignancy. The aim of this study was to study the characteristics and outcomes of pregnant women undergoing surgical intervention for ovarian tumors during pregnancy.
We reviewed the data of 102 pregnant women who underwent ovarian surgery between 2000 and 2010 at Taipei Veterans General Hospital, Taiwan. Data subject to analysis included gestational age at the time of surgery, complications, surgical and pathological findings, and the outcome of pregnancy.
Fifty-two women who underwent surgery were excluded, whether by cesarean section, during the postpartum period or during simultaneous abortion surgery. Ultimately, the data of 50 patients were analyzed. Almost all patients (n = 46, 92%) were asymptomatic and underwent elective surgery. Frequently, this surgery was done in the second trimester (n = 35, 70%). We determined that teratoma (26%), mucinous cystadenomas (20%), and endometriomas (16%) were the three most common pathological findings. Nonspecific ovarian tumors were common (28%), including seven corpus luteum cysts, six simple cysts, and one paratubal cyst. Two women were diagnosed with malignant ovarian tumors, but both were metastatic and the primary site was the colon. Ten women underwent laparoscopic surgery. General anesthesia was used in four patients, and all underwent emergency exploratory laparotomy. There was no surgery-related complication or instance of preterm labor.
In our study cohort, surgical intervention during pregnancy was safe, since neither surgical approach, such as exploratory laparotomy or laparoscopic surgery, nor anesthesia methods, for example general anesthesia or spinal anesthesia showed negative impact on the pregnancy outcomes. Reported cases of malignant ovarian tumor are still rare, thus, the possibility of metastatic tumor should be considered first.
由于胎儿丢失的风险以及与手术相关的并发症的可能性，或者可能出现危及生命的疾病或恶性肿瘤的诊断延迟，妊娠期间卵巢肿瘤的处理具有挑战性。本研究的目的是研究妊娠期间因卵巢肿瘤而行手术干预的孕妇的特征和结局。
我们回顾了台湾台北荣民总医院 2000 年至 2010 年间因卵巢手术而接受治疗的 102 例孕妇的数据。分析的数据包括手术时的孕龄、并发症、手术和病理发现以及妊娠结局。
52 例行手术的孕妇被排除在外，这些手术是通过剖宫产、产后或同时行流产手术进行的。最终，分析了 50 例患者的数据。几乎所有患者（n=46，92%）均无症状并接受了择期手术。这种手术通常在孕中期进行（n=35，70%）。我们确定最常见的三种病理发现是畸胎瘤（26%）、黏液性囊腺瘤（20%）和子宫内膜异位瘤（16%）。非特异性卵巢肿瘤很常见（28%），包括 7 例黄体囊肿、6 例单纯囊肿和 1 例副输卵管囊肿。两名患者被诊断为恶性卵巢肿瘤，但均为转移性，原发灶在结肠。10 名妇女接受了腹腔镜手术。4 名患者使用全身麻醉，所有患者均行急诊剖腹探查术。无手术相关并发症或早产。
在我们的研究队列中，妊娠期间的手术干预是安全的，因为无论是剖腹探查术还是腹腔镜手术等手术方式，还是全身麻醉或脊髓麻醉等麻醉方法，均未对妊娠结局产生负面影响。报告的恶性卵巢肿瘤病例仍然很少，因此，首先应考虑转移性肿瘤的可能性。
