Original ArticleManagement of a Persistent Adnexal Mass in Pregnancy: What Is the Ideal Surgical Approach?
Section snippets
Materials and Methods
After approval by our institutional review board, we performed a retrospective cohort study comparing outcomes in patients who had undergone surgical management of an adnexal mass at 14 weeks or more of gestation. Data were collected for patients seen at our institution between January 1990 and January 2008. Patients were identified using the International Classification of Disease codes for adnexal mass or ovarian neoplasm and pregnancy or antepartum treatment. Both electronic and paper
Results
Between January 1990 and January 2007, 101 consecutive women were identified who underwent surgical management of a second-trimester adnexal mass at our hospital. Of these, 53 women underwent planned laparoscopy and 48 women underwent laparotomy. In the laparoscopy group, there were 3 conversions to laparotomy, and these cases are further considered in the laparotomy cohort. Of the women who underwent conversion to laparotomy, 1 patient had a cystic teratoma that could not be elevated out of
Discussion
In this retrospective study we report intraoperative and postoperative complications of surgically managed second-trimester adnexal masses. To our knowledge, this is the largest study to directly compare the 2 surgical approaches for management of a persistent adnexal mass at 14 weeks or more of gestation. Similar to previous smaller cases series, laparoscopic management of a second-trimester adnexal mass offered advantages over traditional abdominal laparotomy including less morbidity from the
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The authors have no commercial, proprietary, or financial interest in the products or companies described in this article.