Bruno Matteo, Capanna Giulia, Stanislao Veronica, Ciuffreda Raffaella, Tabacco Sara, Fantasia Ilaria, Di Florio Christian, Stabile Guglielmo, D'Alfonso Angela, Guido Maurizio, Ludovisi Manuela
Department of Obstetrics and Gynecology, San Salvatore Hospital, 67100 L'Aquila, Italy.
Department of Clinical Medicine Life Health and Environmental Sciences, University of L'Aquila, 67100 L'Aquila, Italy.
Diagnostics (Basel). 2023 Oct 18;13(20):3247. doi: 10.3390/diagnostics13203247.
(1) Background: The number of adnexal masses detected during pregnancy has increased due to the use of first-trimester screening and increasingly advanced maternal age. Despite their low risk of malignancy, other risks associated with these masses include torsion, rupture and labor obstruction. Correct diagnosis and management are needed to guarantee both maternal and fetal safety. Adnexal masses may be troublesome to classify during pregnancy due to the increased volume of the uterus and pregnancy-related hormonal changes. Management should be based on ultrasound examination to provide the best treatment. The aim of this study was to describe the ultrasound features of ovarian masses detected during pregnancy and to optimize and personalize their management with the expertise of gynecologists, oncologists and sonographers. (2) Methods: Clinical, ultrasound, histological parameters and type of management (surveillance vs. surgery) were retrospectively retrieved. Patient management, perinatal outcomes and follow-up were also evaluated. (3) Results: according to the literature, these masses are most frequently benign, ultrasound follow-up is the best management, and obstetric outcomes are not considerably influenced by the presence of adnexal masses. (4) Conclusions: the management of patients with ovarian masses detected during pregnancy should be based on ultrasound examination, and a centralization in referral centers for ovarian masses should be considered.
(1) 背景：由于孕早期筛查的应用以及产妇年龄的不断增大，孕期发现的附件包块数量有所增加。尽管这些包块的恶性风险较低，但与之相关的其他风险包括扭转、破裂和产道梗阻。需要进行正确的诊断和处理，以确保母婴安全。由于孕期子宫体积增大以及与妊娠相关的激素变化，孕期附件包块的分类可能会比较棘手。处理应基于超声检查，以提供最佳治疗。本研究的目的是描述孕期发现的卵巢包块的超声特征，并借助妇科医生、肿瘤学家和超声科医生的专业知识，优化并个性化其处理方式。(2) 方法：回顾性收集临床、超声、组织学参数以及处理类型（监测与手术）。还评估了患者的处理方式、围产期结局及随访情况。(3) 结果：根据文献，这些包块大多为良性，超声随访是最佳处理方式，附件包块的存在对产科结局没有显著影响。(4) 结论：孕期发现卵巢包块患者的处理应基于超声检查，并且应考虑将患者转诊至卵巢包块诊治中心。
