Dynamic Changes of Ovarian Masses During Pregnancy and the Effects on Pregnancy Outcomes.

Abstract

Background: To investigate the dynamic changes in ovarian mass size during pregnancy and the impact of different management methods for ovarian masses on pregnancy outcomes.

Methods: A multicenter retrospective analysis of 177 pregnant women with ovarian masses (142 follow-up and 35 surgical cases) assessed mass size via ultrasound, analyzed its dynamic changes and risk factors, reviewed management impacts on perinatal outcomes, and calculated pathological type distributions.

Results: Compared to first trimester, the maximum diameter and volume of ovarian masses significantly decreased in the third trimester. Furthermore, compared to third trimester, the maximum diameter and volume of these masses were further reduced postpartum (p < 0.05). Multivariate regression demonstrated that age (OR [95% CI]: 0.888 [0.788-0.999]) and prepregnancy BMI (OR [95% CI]: 1.179 [1.013-1.373]) were factors influencing the increase in the size of ovarian masses during pregnancy. Pregnancy outcomes in the surgery-during-pregnancy group did not find significant difference compared to the follow-up group (p > 0.05). Additionally, the predominant pathological type of ovarian mass during pregnancy was mature cystic teratoma (40%), and the overall malignancy rate of the ovarian masses was 2.5%.

Conclusions: The size of ovarian masses showed a decreasing trend as pregnancy progresses. Higher prepregnancy BMI and younger age were risk factors for the increase in ovarian mass size during pregnancy. Furthermore, when performed appropriately, surgical intervention for ovarian masses during pregnancy was safe. Mature cystic teratoma was the most prevalent pathological entity of ovarian mass treated surgically during pregnancy.