We report a case of an ovarian cyst in pregnancy complicated by torsion of the cyst requiring urgent surgical intervention at 13 weeks of gestation. The case was successfully managed by laparoscopic ovarian cystectomy without any maternal or fetal complications. Thus proving that operative laparoscopy in pregnancy is a safe and feasible option. Approximately 0.2% of pregnant women require intra-abdominal general surgery during pregnancy. Benefits of laparoscopic surgery compared to the traditional open surgery are well recognised; notably, a shorter hospital stay and a reduced rate of post-operative complications. Pregnancy poses unique surgical and anaesthetic problems due to altered physiology and anatomy in pregnancy. The effect of the pneumoperitoneum on the maternal haemodynamic status, risk of uterine/fetal damage by trocar entry, risk of miscarriage and preterm labour are some serious concerns that may limit the feasibility and safety of operative laparoscopy in pregnancy. In the past few decades, there has been increasing evidence emerging in the medical literature supporting the safety of operative laparoscopy in pregnancy. The second trimester is considered to be the safest period in terms of least risk to the fetus and also seems more favourable for the technical aspect of the laparoscopic procedures. Hasson's method of laparoscopic entry technique is prudent to avoid possible uterine injury. Although absolute safety of laparoscopic surgery during pregnancy in humans is yet to be established, presently, operative laparoscopy by an experienced laparoscopist is considered a safe and effective alternative to traditional laparotomy. Prospective randomised controlled studies in this clinical territory are lacking. Keywords Laparoscopy . Pregnancy . Adnexal mass . Pregnancy complications Case reportA 22-year-old woman in her first pregnancy attended her dating scan at 11 weeks and incidentally revealed a multiloculated cystic mass in the left ovary measuring 87 × 74 × 41 mm. She gave a background history of gradually worsening right sided lower abdominal pain for about 6 months.Ovarian tumour markers were not done as they have a limited value in evaluating ovarian cysts in pregnancy; because, during pregnancy, tumour markers such CA 125, beta-hCG, alpha-fetoprotein and inhibin levels are raised due to desidual and placental synthesis.Conservative management with serial follow up scans was agreed upon with provision for surgery in the case of cyst complication or suspicion of malignancy. Should elective surgery be necessary, 14 weeks of gestation and beyond in the second trimester is considered to be the optimal time period in a bid to mitigate the risk of fetal loss.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.