Management of borderline ovarian tumors in pregnancy: A Retrospective Analysis

Abstract

Objective: To evaluate the clinical and histopathological characteristics of borderline ovarian tumors in pregnancy, the prognosis after surgery at different stages of pregnancy, and maternal and neonatal outcomes, with the aim of providing a basis for the optimal management strategy of borderline ovarian tumors in pregnancy. Materials and Methods: Twenty-fourpatients with borderline ovarian tumors who were treated from January 2011 to March 2022 and diagnosed during pregnancy or postpartumwere enrolled. All medical records were reviewed to extract clinical and obstetric characteristics, histological tumor characteristics, surgical procedure, and follow-up. Results: Four patients (17%) were diagnosed during the first trimester of pregnancy, 6 (25%) during the second trimester, 12 (50%) during the third trimester, and 2 (8%) in postpartum. More Unilateral cystectomies (46%) were performed than unilateral cystectomies (29%), and more unilateral cystectomies plus contralateral cystectomies (17%) were performed than bilateral cystectomies (8%). Three patients with ruptured masses were found intraoperatively in the third trimester. Serous mucinous borderline ovarian tumorsaccountedfor 25% (6/24), and mixed borderline ovarian tumors (mucous/translucent) accounted for 4% (1/24). FIGO stage I accounted for 92% of the patients (22/24). Eight percentwere classified (2/24) as stage III, both of which were bilateral SBT-micro papilla subtypes. Full-term pregnancies accounted for 87.5% of the patients (21/24). Of the 21 patients who delivered, 43% (9/21) had a normal delivery. A total of 19 newborns had a one-minute Apgar scoreof 10. Recurrence occurred in 12.5% of the patients (3/24). Five patients had a previous history of borderline ovarian tumor. Two patients (8%) had two episodes of borderline ovarian tumor before the current pregnancy, and three (13%) had one episode. No postoperative malignancy was found in any patient. Conclusion: Pregnancy does not worsen the prognosis of borderline ovarian tumors, even with multiple recurrences, and progression does not occur even with conservative observation throughout pregnancy and management after delivery. Borderline ovarian tumorsdo not affect the mode of delivery. There were no differences in maternal and neonatal pregnancy outcomes at different stages of pregnancy or in postpartum management of borderline ovarian tumors.