Comparison of subsequent pregnancy outcomes after surgery for adnexal masses performed in the first and second trimester of pregnancy

Int J Gynaecol Obstet. 2020 Mar;148(3):305-309. doi: 10.1002/ijgo.13065. Epub 2019 Dec 11.

Abstract

Objective: To determine whether surgery for adnexal masses in the first trimester of pregnancy affects subsequent pregnancy outcomes compared to surgery in the second trimester.

Methods: Data were retrospectively reviewed from women who underwent adnexal mass surgery before 26 weeks of gestation at a university hospital between July 2008 and June 2018. Women who underwent surgery in the first trimester were classified as group 1 (n=78) and those in the second trimester were classified as group 2 (n=48). Information on clinical characteristics and pregnancy outcomes was obtained from medical records and follow-up interviews and compared between two groups.

Results: There were no differences in age, parity, mass size, laparoscopy, and operation time between the two groups. A total of 98 cases were confirmed as ovarian torsion, including 72 cases in group 1 and 26 cases in group 2. Accordingly, adnexectomy was performed more often in group 1 (P=0.002). No significant differences concerning the rate of abortion, preterm birth, or cesarean delivery were found.

Conclusion: Surgery for adnexal masses performed in the first trimester is almost as safe as that in the second trimester. Surgery should be performed for women with a complex adnexal mass in the first trimester to avoid unfavorable complications.

Keywords: Adnexal masses; Adnexal torsion; First trimester; Pregnancy outcomes; Second trimester; Surgery.

Publication types

  • Comparative Study

MeSH terms

  • Adnexal Diseases / surgery*
  • Adult
  • Cesarean Section / statistics & numerical data
  • Female
  • Humans
  • Infant, Newborn
  • Laparoscopy / adverse effects
  • Laparoscopy / statistics & numerical data
  • Pregnancy
  • Pregnancy Complications, Neoplastic / surgery*
  • Pregnancy Outcome / epidemiology*
  • Pregnancy Trimester, First*
  • Pregnancy Trimester, Second*
  • Premature Birth / epidemiology
  • Retrospective Studies