Outcome in laparoscopic management of persistent adnexal mass during the second trimester of pregnancy

Abstract

Background: This study evaluated the safety of laparoscopic management for persistent adnexal mass in the second trimester of pregnancy.

Methods: Between April 1994 and March 2003, 67 consecutive women underwent laparoscopic removal of adnexal masses that had persisted into the second trimester of pregnancy in an academic tertiary referral center. Operative complications, pregnancy, and labor outcomes were evaluated.

Results: The median gestation was 10.5 weeks (range, 5-25 weeks) at diagnosis and 16 weeks (range, 12-25 weeks) at the time of operation. Only two women required for conversion to laparotomy. Cystectomy was performed for 55 women, oophorectomy for 9 women and fenestration in 3 women. There were no intraoperative complications or major postoperative complications. No women were given tocolytic therapy, and none experienced uterine contractions. There was one spontaneous abortion 6 weeks after the operation, and one patent was lost to follow up. Of the remaining 65 women, the median gestation at delivery was 39 weeks (range, 33-42 weeks), and the median birthweight was 3,160 g (range, 2,220-4,200 g).

Conclusions: Laparosocpic surgery for persistent adnexal masses in the second trimester of pregnancy is safe when performed by experienced surgeons.