Abstract
INTRODUCTION:The purpose of our study is to estimate the incidence of adnexal mass and ovarian cancer during pregnancy and to evaluate their effects on obstetric and fetal outcomes.
METHODS:We conducted a population-based cohort study using data from the Healthcare Cost and Utilization Project–Nationwide Inpatient Sample. Cases of ovarian mass during delivery were identified using the International Classification of Diseases, 9th Revision and subsequently categorized into groups of malignant and benign masses. Logistic regression analysis was used to evaluate maternal and fetal outcomes.
RESULTS:There were 7,785,583 deliveries between 2003 and 2011 of which 19,591 were diagnosed with ovarian masses during delivery, representing 0.25% of all deliveries. Among these, one in 200 was malignant. The overall malignancy rate was 0.12 per 10,000 deliveries. Apart from the increased rate of cesarean delivery (odds ratio [OR] 5.92, 95% confidence interval [CI] 4.12–8.40) and the risk of thrombosis (OR 5.52, 95% CI 1.96–15.53), there was no significant increase in maternal morbidity or mortality. Prematurity (OR 2.24, 95% CI 1.48–3.40) was the only significant newborn risk in women with malignant ovarian tumors. Newborns of women with an ovarian mass had comparable risks of intrauterine growth restriction, preterm rupture of membranes, and intrauterine death.
CONCLUSION:The diagnosis of an ovarian mass is rare during pregnancy and it is associated with an extremely low malignancy rate. Pregnant woman with a confirmed malignant ovarian tumor should be counseled regarding risks of prematurity, thrombosis, and hysterectomy.