BibTex RIS Cite

Coincidental adnexal neoplasms at cesarean section

Year 2004, Volume: 35 Issue: 2, 61 - 66, 01.03.2004

Abstract

Objective: To examine adnexial masses which were found accidentally during cesarean section ( CIS) and evaluate these findings with literatere review. Material and Methods: This study was performed on Zeynep Kamil Hospital between January and December 2002. In this period, the patients who wewe delivered by sectio cesarean (CIS) evaluated retrospectively according to hospital records. All patients had CIS because of obstetrical indications and their adnexial masses were not diagnosed before CIS . They found accidentally. The patients' number was 42. Result: In this study, mean age was 24.4 (17-41), mean pregnancy number was 3.2 (1-8). Twelve of the patients 28.5 % were nulliparous, thirty (71.5%) patients were multiparous.Indications of CIS were previous CIS, fetal distress and fetal malpresentation their numbers were 11,19,12 respectivelyAdnexial masses were not found before CIS for all these patients.Histopathologically paratubal cyst was found with highest number of presentation corpus luteum cyst (9 patients,21.4%), mucinous cystadenom 6 patients (14.3 %) benign teratom ;5patients( 11.9%), serous cystadenom 3 patients( 7.1%), endometrioma 1 patient and fibrotechoma 1 patient were diagnosed histopathologically. Malignancy was not present for that group. Adnexial masses were found bilaterally for two patients. Mass sizes changed between 1.5 xl.O cm. (the smallest one), 22x18 cm .(the largest one). Nineteen patients had adnexial masses bigger than 6 cm in volume. Conclusion: Pregnancy complicated adnexal masses if mass size become 6cm than bigger, asymptomatic no malign screening test characterstics .exploratory laparotomy desicion will be agressive because of perinatal morbidity. We recommend observation in asymptomatic pregnants until labor if It become emergency situation.

References

  • 1. Sanfilippo JS, RockJA. Surgery for benign disease of the ovary. In RockfA, Jones HW, eds. Te Linde's Operative Gynecology, 9th ed. Lippincott Williams Wilkins, 2003:644-5
  • 2. Whitecar MP, Turner S, Higby K. Adnexal masses in pregnancy : A review of 130 cases undergoing surgical management. Am J Obstet Gynecol 1999; 181 : 19-24
  • 3. Facobs JH; Stringer CA: Diagnosis and management of cancer during pregnancy. Semin Perinatol 1990; 14:79-82
  • 4. Joshi SN, Limb DG;. Ovarian cysts complicating pregnancy. J Obstet Gynecol 1985; 5 : 149-152
  • 5. Koonings PP; Platt LD, Wallace R. Incidental adnexal neoplasms at cesarean section . Obstet Gynecol 1988; 72 : 767-772
  • 6. Resta P, Nardelli GB, Ambrosini A, et al.Limits of echography in the evaluation of ovarian tumors Clin. Exp Obstet Gynecol 1982; 9 :165-172
  • 7. Novak ER, Lambrou CD, Woodruff JD. An ovarian tumors in pregnancy; an ovarian tumor registry review. Obstet Gynecol 1975; 46 : 401-6
  • 8. Katz VL, Watson Wf, Hansen WF, Washington JL Massive ovarian tumor complicating pregnancy. A case report. J Reprod Med 1993; 38 : 907-910
  • 9. Kier R, Me Carthy SM, Scoutt LM, Viscarello rr, Schwartz PE.Pelvic masses in pregnancy: MR Imaging.Radiology 1990; 176: 709-712
  • 10. Kurjak A, Zalud I:Transvaginal color Doppler for evaluating gynecologic pathology of the pelvis.Ultraschall Med.1990; 11: 164-167
  • 11. Spitzer M, Kaushal N, Benjamin E Maternal CA-125 levels in pregnancy and the puerperium.J Reprod Med 1998; 43: 387-391
  • 12. Frederiksen MC, Casanova L, Schink JC.An elevated maternal serum alphafetoprotein leading to the diagnosis of an immature teratoma. Int J Gynaecol Obstet.1991; 35: 343-346
  • 13. Montz FJ, Horenstein J, Platt LD, d'Ablaing G,SchlaerthJB, Cunningham G. The diagnosis of immature teratoma by maternal serum alpha - fetoprotein screening. Obstet Gynecol 1989; 73: 522-525
  • 14. Hopkins MP, Duchon MA, Adnexal surgery in pregnancy. J.Reprod Med 1986; 31: 1035-1038
  • 15. Beischer NA, Buttery BW, Fortune DW, et al. Growth and malignancy of ovarian tumors in pregnancy. Aust N Z Obstet Gynaecol 1971; 11:208-211
  • 16. Platek DN, Henderson CE, Goldberg GL, The menegement of a persistent adnexal mass in pregnancy Am J Obstet Gynecol 1995; 62.251-255
  • 17. Caspi B, Levi R, Appelman Z,Rabinerson D, Goldman G, Hagay Z, Conservative management of ovarian cystic teratoma during pregnancy and labor.Am J Obstet Gynecol 2000; 182: 347-351
  • 18. Mazze BI, Kalen B. Reproductive outcome after anesthesia and operation during pregnancy: A registry study of 5405 cases. Am J Obstet Gynecol 1989; 161: 1178-1182
  • 19. Sylvester GC, Khoury MJ, Lu X, Erickson JD. First-trimester anesthesia exposure and the risk of central nervous system defects; A population-based case-control study.Am J Public Health 1994; 84: 1757-1762
  • 20. Czeizel AE, Pataki T, Rockenbauer M.Reproductive outcome after exposure to surgery under anesthesia during pregnancy .Arch Gynecol Obstet 1998; 261:193-198
  • 21. Hess LW, Peaceman A, O'Brien WF, Winkel CA, Cruikshank DW, Morrison JC.Adnexal mass occuring with intrauterine pregnancy: Report of fifty-four patients ruquiring laparotomy for definitive management.Am J Obstet Gynecol 1998; 158:1029-032. 22. Rosen MA. Management of anesthesia for the pregnant surgical patient. Anesthesiology 1999; 91: 1159-1163

Sezaryen sırasında tesadüfen saptanmış adneksiyal kitleler

Year 2004, Volume: 35 Issue: 2, 61 - 66, 01.03.2004

Abstract

Amaç: Sezaryen sırasında tesadüfi olarak saptanmış adneksiyal kitlesi olan vakaların incelenmesi ve literatür bilgileri ışığında değerlendirilmesi yapılmıştır. Materyal ve Metod: Bu çalışma, Zeynep Kamil Kadın Hastalıkları ve Doğum Hastanesinde Ocak 1995 -Aralık 2002 yılları arasında sezaryen ile doğum yapmış hastaların, dosya kayıtlarının retrospektif olarak incelenmesiyle yapıldı. Tamamen obstetrik endikasyonlarla sezaryene alınan ve tesadüfi olarak adneksiyal kitle saptanan olgular seçildi, sezaryen öncesinde adneksiyal kitlesi olduğu bilinen hastalar çalışmaya alınmadı. Toplam 42 olgu vardı. Bulgular: Olguların ortalama yaşı 24.4 (17- 41),ortalama gebelik sayısı 3.2 ( l-8)di.Hastaların 12 (%28.5)si nullipar , 30 (%71.5)u multipardı. Sezaryen endikasyonlan; 11 (%26.1) olguda eski sezaryen, 19 (%45.2) unda fetal distress, 12 (%28.5) sinde fetal malprezantasyon olup hiçbirisinde operasyon öncesinde adneksiyal kitleden şüphelenilmemişti. Histopatolojik tanılarına göre; en çok tesbit edilen 17 vaka (% 40.4)ile paratubal kist olup bunu sırasıyla ; 9 olguda (%21.4) corpus luteum kisti, 6 (%14.3) sında müsinöz kistadenom, 5 (%11.9)inde benign teratom, 3 (%7.1) ünde seröz kistadenom ve birer vaka ile endometrioma ve fibrotekoma izlemektedir. Hiçbir olguda maligniteye rastlanmadı. İki vakada adneksiyal kitle bilateraldi.Kitle büyüklüğü, en küçük 1.5x 1.0 cm, en büyük 22 x 18 cm. arasında değişmekteydi. Vakalann 19'unda adneksiyal kitle çapı 6 cm den büyüktü. Sonuç: Adneksiyel kitle ile komplike olmuş gebeliklerde, kitle 6 cm den büyük ve ikinci trimesterde de sebat ediyor ama asemptomatik ve görüntüleme yöntemleri ile değerlendirildiğinde malignite kriterleri taşımıyorsa; laparotomi kararı perinatal morbiditeyi artıracak agressif bir karar olabilir. Hasta yakın takiple miadına kadar izlenebilir ve akut bir komplikasyon çıkmadıkça laparotomi gebelik sonrasına ertelenebilir.

References

  • 1. Sanfilippo JS, RockJA. Surgery for benign disease of the ovary. In RockfA, Jones HW, eds. Te Linde's Operative Gynecology, 9th ed. Lippincott Williams Wilkins, 2003:644-5
  • 2. Whitecar MP, Turner S, Higby K. Adnexal masses in pregnancy : A review of 130 cases undergoing surgical management. Am J Obstet Gynecol 1999; 181 : 19-24
  • 3. Facobs JH; Stringer CA: Diagnosis and management of cancer during pregnancy. Semin Perinatol 1990; 14:79-82
  • 4. Joshi SN, Limb DG;. Ovarian cysts complicating pregnancy. J Obstet Gynecol 1985; 5 : 149-152
  • 5. Koonings PP; Platt LD, Wallace R. Incidental adnexal neoplasms at cesarean section . Obstet Gynecol 1988; 72 : 767-772
  • 6. Resta P, Nardelli GB, Ambrosini A, et al.Limits of echography in the evaluation of ovarian tumors Clin. Exp Obstet Gynecol 1982; 9 :165-172
  • 7. Novak ER, Lambrou CD, Woodruff JD. An ovarian tumors in pregnancy; an ovarian tumor registry review. Obstet Gynecol 1975; 46 : 401-6
  • 8. Katz VL, Watson Wf, Hansen WF, Washington JL Massive ovarian tumor complicating pregnancy. A case report. J Reprod Med 1993; 38 : 907-910
  • 9. Kier R, Me Carthy SM, Scoutt LM, Viscarello rr, Schwartz PE.Pelvic masses in pregnancy: MR Imaging.Radiology 1990; 176: 709-712
  • 10. Kurjak A, Zalud I:Transvaginal color Doppler for evaluating gynecologic pathology of the pelvis.Ultraschall Med.1990; 11: 164-167
  • 11. Spitzer M, Kaushal N, Benjamin E Maternal CA-125 levels in pregnancy and the puerperium.J Reprod Med 1998; 43: 387-391
  • 12. Frederiksen MC, Casanova L, Schink JC.An elevated maternal serum alphafetoprotein leading to the diagnosis of an immature teratoma. Int J Gynaecol Obstet.1991; 35: 343-346
  • 13. Montz FJ, Horenstein J, Platt LD, d'Ablaing G,SchlaerthJB, Cunningham G. The diagnosis of immature teratoma by maternal serum alpha - fetoprotein screening. Obstet Gynecol 1989; 73: 522-525
  • 14. Hopkins MP, Duchon MA, Adnexal surgery in pregnancy. J.Reprod Med 1986; 31: 1035-1038
  • 15. Beischer NA, Buttery BW, Fortune DW, et al. Growth and malignancy of ovarian tumors in pregnancy. Aust N Z Obstet Gynaecol 1971; 11:208-211
  • 16. Platek DN, Henderson CE, Goldberg GL, The menegement of a persistent adnexal mass in pregnancy Am J Obstet Gynecol 1995; 62.251-255
  • 17. Caspi B, Levi R, Appelman Z,Rabinerson D, Goldman G, Hagay Z, Conservative management of ovarian cystic teratoma during pregnancy and labor.Am J Obstet Gynecol 2000; 182: 347-351
  • 18. Mazze BI, Kalen B. Reproductive outcome after anesthesia and operation during pregnancy: A registry study of 5405 cases. Am J Obstet Gynecol 1989; 161: 1178-1182
  • 19. Sylvester GC, Khoury MJ, Lu X, Erickson JD. First-trimester anesthesia exposure and the risk of central nervous system defects; A population-based case-control study.Am J Public Health 1994; 84: 1757-1762
  • 20. Czeizel AE, Pataki T, Rockenbauer M.Reproductive outcome after exposure to surgery under anesthesia during pregnancy .Arch Gynecol Obstet 1998; 261:193-198
  • 21. Hess LW, Peaceman A, O'Brien WF, Winkel CA, Cruikshank DW, Morrison JC.Adnexal mass occuring with intrauterine pregnancy: Report of fifty-four patients ruquiring laparotomy for definitive management.Am J Obstet Gynecol 1998; 158:1029-032. 22. Rosen MA. Management of anesthesia for the pregnant surgical patient. Anesthesiology 1999; 91: 1159-1163
There are 21 citations in total.

Details

Primary Language Turkish
Journal Section Articles
Authors

İlknur Aköz This is me

Kiliççi Çetin This is me

Kutlu Tayfun This is me

Pekin Oya This is me

Eren Sadiye This is me

Publication Date March 1, 2004
Published in Issue Year 2004 Volume: 35 Issue: 2

Cite

APA Aköz, İ., Çetin, K., Tayfun, K., Oya, P., et al. (2004). Sezaryen sırasında tesadüfen saptanmış adneksiyal kitleler. Zeynep Kamil Tıp Bülteni, 35(2), 61-66. https://doi.org/10.16948/zktb.18337
AMA Aköz İ, Çetin K, Tayfun K, Oya P, Sadiye E. Sezaryen sırasında tesadüfen saptanmış adneksiyal kitleler. Zeynep Kamil Tıp Bülteni. March 2004;35(2):61-66. doi:10.16948/zktb.18337
Chicago Aköz, İlknur, Kiliççi Çetin, Kutlu Tayfun, Pekin Oya, and Eren Sadiye. “Sezaryen sırasında tesadüfen saptanmış Adneksiyal Kitleler”. Zeynep Kamil Tıp Bülteni 35, no. 2 (March 2004): 61-66. https://doi.org/10.16948/zktb.18337.
EndNote Aköz İ, Çetin K, Tayfun K, Oya P, Sadiye E (March 1, 2004) Sezaryen sırasında tesadüfen saptanmış adneksiyal kitleler. Zeynep Kamil Tıp Bülteni 35 2 61–66.
IEEE İ. Aköz, K. Çetin, K. Tayfun, P. Oya, and E. Sadiye, “Sezaryen sırasında tesadüfen saptanmış adneksiyal kitleler”, Zeynep Kamil Tıp Bülteni, vol. 35, no. 2, pp. 61–66, 2004, doi: 10.16948/zktb.18337.
ISNAD Aköz, İlknur et al. “Sezaryen sırasında tesadüfen saptanmış Adneksiyal Kitleler”. Zeynep Kamil Tıp Bülteni 35/2 (March 2004), 61-66. https://doi.org/10.16948/zktb.18337.
JAMA Aköz İ, Çetin K, Tayfun K, Oya P, Sadiye E. Sezaryen sırasında tesadüfen saptanmış adneksiyal kitleler. Zeynep Kamil Tıp Bülteni. 2004;35:61–66.
MLA Aköz, İlknur et al. “Sezaryen sırasında tesadüfen saptanmış Adneksiyal Kitleler”. Zeynep Kamil Tıp Bülteni, vol. 35, no. 2, 2004, pp. 61-66, doi:10.16948/zktb.18337.
Vancouver Aköz İ, Çetin K, Tayfun K, Oya P, Sadiye E. Sezaryen sırasında tesadüfen saptanmış adneksiyal kitleler. Zeynep Kamil Tıp Bülteni. 2004;35(2):61-6.