Surgical Management of Adnexal Masses in Pregnancy



Surgical Management of Adnexal Masses in Pregnancy


Eva Hoffmann

Maria Andrikopoulou

Andrea Tinelli

Farr Nezhat



GENERAL PRINCIPLES



Adnexal Pathology


Functional Cysts



  • Simple (Figure 3.5.13) and hemorrhagic cysts are the most common cysts diagnosed during pregnancy (3). On ultrasound, simple cysts appear as anechoic, unilocular structures with smooth thin walls (Figure 3.5.14). Hemorrhagic cysts may have different appearances on ultrasound owing to the changing structure of blood clots that are usually present. They can appear as anechoic masses with hypoechoic material within the adnexal mass. They can also appear as echoic masses with internal echoes that are more hyperechoic than the surrounding normal ovarian tissue. Both simple and hemorrhagic cysts will usually regress as the pregnancy progresses (3).


Dermoid Mass



  • Dermoid cysts have distinct ultrasound characteristics. They often contain solid and cystic components (Figure 3.5.15). On ultrasound, they have a complex echo pattern and can

    have acoustic shadowing because of the fat content and calcified nature of their structures. In most cases, ultrasound is sufficient to characterize a dermoid cyst, but magnetic resonance imaging (MRI) may also be useful in getting more information and differentiating from other pelvic masses. Dermoid cysts can be associated with complications such as adnexal torsion (Figure 3.5.16), given their dense structure; they can also rupture, causing peritonitis.



































































Endometrioma

Sep 8, 2022 | Posted by in OBSTETRICS | Comments Off on Surgical Management of Adnexal Masses in Pregnancy
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