Management of adnexal mass in pregnancy TOG 2017 Flashcards
When does the corpus luteal cyst normal regress in pregnancy?
8th week
Highly vascular cyst, prone to haemorrhage/rupture
When do follicular cysts normally resolve by?
16 weeks
What is hyperreactio luteinalis
Similar to OHSS, ovaries respond to bHCG
Rate of maternal virilisation in hyperreactio luteinalis
14-25%
What is luteoma of pregnancy?
Rare condition, benign luteinised storm cells replace ovarian parchynma
Maternal virilisation occurs in what % of luteoma of pregnancy?
25-50%
When virilisation occurs, 50% risk virilisation. of female fetus
In ART how common is heterotypic pregnancy?
1-2%
Dermoid cysts over what size are most likely to tort in prengnacy?
> 6cm
27% risk
What % of adnexal masses in pregnancy are simple ovarian cysts <5cm
76%
Will resolve by 16 weeks
If couplex or larger cyst identified when should be rescanned?
14-16 weeks
If benign can manage conservatively
What are the indications for surgery for ovarian cyst in pregnancy?
Acute abdomen
Mass suspicious for malignancy
Rapidly growing (increase >20%)
Cysts >10cm which may obstruct labour
What is the risk of ovarian torsion in OHSS
16%
If suspected malignant mass in pregnancy
1st trimester: discuss risk miscarriage, TOP (especially if advanced disease)
Late 2nd/3rd: Early delivery CS, surgery, can commence chemo in prengnancy
Draw diagram for management of adnexal masses in prengay
1) Acute abdomen
2) Asymotomatic
- bengin
- intermediate
- suspicious
