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Pregnancy and Ovarian Tumors
Last reviewed: 23.04.2024
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Ovarian tumors occur in 0.1-1.5% of pregnant women. Their structure is different: cysts, real ovarian tumors, ovarian cancer. The beginning of the formation of the ovarian neoplasm is extremely difficult to determine, since the clinical manifestations are most often not expressed if there is no soreness in the shift of the cyst or in the re-circling of the cyst leg.
[Symptoms of ovarian tumors in pregnancy
In connection with the lack of expression of the clinical picture, neoplasms of the ovaries in the second trimester of pregnancy are found in a bimanual vaginal-abdominal study. In the long term of pregnancy, they can be detected by palpation of the abdomen or vaginal examination. Most often, tumors of different size and consistency are found on the side of the uterus, when they are placed behind the uterus, difficulties arise in the diagnosis. A valuable additional method of diagnosing neoplasm of the ovaries is ultrasound.
When twisting the legs of the cyst or rupturing the capsule of the cyst, the symptoms of an acute abdomen appear: pain, nausea, vomiting, tachycardia, lagging of the tongue, tenderness in palpation, symptoms of irritation of the peritoneum.
If a cyst is detected during pregnancy and in the absence of a clinic for an acute abdomen, the cyst should not be removed until 16-18 weeks. Pregnancy, as it persists the yellow body of pregnancy (during surgery, pregnancy can be interrupted on the background of progesterone insufficiency). After 16-18 weeks. Pregnancy function of the persistent yellow body of pregnancy should take the placenta, and then the cyst on the ovary itself can disappear This requires dynamic ultrasound. When clinical symptoms of an acute abdomen appear, an operation is performed and the cyst is removed, followed by a histological examination. In the post-operative period, therapy is conducted to preserve the pregnancy. During surgery you can use as a laparotomy, hook and laparoscopic access.
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Conduction of labor for ovarian tumors
The management of labor depends on whether the tumor prevents the birth of a child. If the tumor interferes with childbirth, then perform cesarean section and remove the altered appendages of the uterus, and healthy appendages during surgery must be carefully inspected.
Usually, neoplasms of the ovaries do not create obstacles for the passage of the fetus along the generic pathways and the labor ends satisfactorily. And only in the postpartum period, depending on the nature of the clinical picture, the question of the scope of the surgical intervention is decided.
Detection of ovarian cancer is an indication for the operation regardless of the gestational age. At the first stage, you can remove the altered ovaries and omentum. When the viability of the fetus is achieved, cesarean section and extirpation of the uterus with appendages, resection of the omentum, and later chemotherapy are performed.