Outcomes of Asymptomatic Adnexal Masses in Pregnancy

Abstract

Objective: To investigate the outcome of asymptomatic adnexal masses in pregnancy detected before 16 weeks of gestation.
Methods: This was a retrospective study on asymptomatic adnexal masses in pregnancy. The outcomes of all the adnexal masses incidentally diagnosed by routine scans before 16 weeks of gestation detected between 1 July 2006 and 30 June 2007 in the Tuen Mun Hospital, Hong Kong were reviewed.
Results: An adnexal mass was found in 6% (182/2958) pregnancies. Of these, 164 patients had complete follow-up. The majority (77%) of these adnexal masses were simple cysts with a mean diameter of 5 cm or less and 93% (123/132) of them resolved spontaneously during pregnancy. The overall resolution rate for other groups was 56% (20/36). Eight persistent adnexal masses were removed surgically and none of them were malignant. No adnexal masses in the study period caused complications such as torsion or obstructed labour. Among the possible predictive factors for the persistence of the adnexal mass, only its size was a statistically significant factor.
Conclusion: Our data support conservative management for asymptomatic small simple cysts diagnosed during pregnancy. The need for subsequent follow-up scans in this group during the antenatal period is minimal, due to their benign nature and minimal risk of complications or adverse outcomes.