Benign ovarian cysts during pregnancy are relatively common, and in the first trimester, if there is a diameter greater than or equal to 10 cm, ovarioplasty is indicated. videolaparoscopic, while in patients with cysts less than six centimeters in diameter, standby management may be used. But is expectant management really safe? How many patients end up having emergency surgery? Would it be safer to perform laparoscopic ovarioplasty in the second trimester? Even in patients with a benign ovarian cyst of smaller diameter?
Recent analysis on the surgical treatment of benign ovarian cysts
In July 2022, a article Nope Obstetrics and Gynecology Research Journal, to review and compare the outcomes of benign ovarian cysts treated with elective laparoscopic surgery or emergency surgery during pregnancy. From 2004 to 2017, researchers treated 135 pregnant women (110 electives and 25 emergencies) with ovarian cysts and compared surgical and perinatal outcomes.
According to the authors of the article in question, there was no significant difference in the diameter of the cysts, but cysts < 6 cm were significantly more frequent in the emergency cases (36 %) than in the elective cases (15%). Mature teratomas were significantly more common in elective cases (89% versus 52%), and corpus luteum cysts were more common in emergency cases (0% versus 32%). Rates of laparoscopic surgery (98.2% versus 52.0%) and ovarian conservation (99.1% versus 80.0%) were significantly higher, and postoperative hospitalization was significantly lower in elective cases than in emergency cases. There was no significant difference in gestational age at delivery (38.9 1.9 vs 38.4 2.7 weeks), preterm delivery rate (12% vs 20%) or birth weight (2939,469 vs 3019,510 g).
It’s not uncommon to need emergency surgery in pregnant women with a benign ovarian cyst, but emergency surgery carries greater risks than elective surgery. Thus, elective laparoscopic surgery is indicated and safe even for benign ovarian cysts of smaller diameter (about 5 cm) in pregnant women during the second trimester of pregnancy.
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