Adnexal masses in the third trimester of pregnancy in Mahdieh Hospital, Tehran, between 2002 and 2006

The prevalence of adnexal tumour has been reported to varybetween one in eight thousands to 2.3% of pregnancies according to investigationaltechniques administered. broader use of ultrasonography in pregnancy and theincreasing rate of caesarean section (c-section) could be expected to lead to thediagnosis of more adnexal tumours compared to previous studies.aim and objectives: to identify the histological types, clinical manifestations,prevalence of malignant forms, and to assess the risk of two selected treatmentapproaches i.e. surgical (invasive) vs. conservative.method: this retrospective descriptive study was conducted on patients admitted tomahdieh hospital, tehran, between 2002-2006 with confirmed adnexal tumours inthe third trimester of pregnancy. patients’ medical records were reviewed for age,gestational age, parity, the reason for admission, diagnostic approach for adnexaltumour, ultrasound characteristics (where available), surgical and histopathologicalfindings.results: in all, 45 patients were recognised. mean age was 27.8 (±4.8) and meangravity was 2.1 (±1.2). incidence rate for surgically confirmed adnexal malignancyin the third trimester was one in 570 live births and one in every 184 caesareansection. in forty three patients, diagnosis and tumour resection occurred duringcaesarean section of whom the reason for c-section was the adnexal mass in fivecases, 33 were accidentally found during c-section due to obstetrics indications andthe remainder (5 cases) was due to both causes. one case underwent tumourresection after post-partum tuboligation and one after vaginal delivery followed bylaparatomy. no complication due to malignancy was found. diagnostic procedurewas ultrasonography only in 10 patients (23%). of whom, half were in the thirdtrimester and half were detected in the first trimester with the adnexal mass being5-10 cm in diameter. all were benign in line with histological features. in 35patients, no mass was reported despite ultrasonography. all had benign features inhistopathology and the most frequent diagnosis was paratubal cyst followed byserous-cyst adenoma.conclusion: adnexal tumour complications in the third trimester are not frequentand the risk of malignancy is low. therefore, if diagnosed, it is not a definiteindication for an urgent surgical intervention provided that ultrasonographic featureof the mass is benign.