Skip to main content

Incidence of maternal and neonatal outcomes in pregnancies complicated by ovarian masses

Abstract

Purpose

The purpose of our study is to estimate the incidence of adnexal mass and ovarian cancers during pregnancy and to evaluate their effects on obstetrical and fetal outcomes.

Methods

We conducted a population-based cohort study using data from The Healthcare Cost and Utilization Project-Nationwide Inpatient Sample. Cases of ovarian mass during delivery were identified using International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM). Women were categorized into subgroups of malignant and benign masses. Logistic regression analysis was used to evaluate maternal and fetal outcomes.

Results

There were 7,785,583 deliveries between 2003 and 2011, of which 19,591 were diagnosed with ovarian masses during delivery, representing 0.25 % of all deliveries. Among these, 1:200 were malignant. The overall malignancy rate was 0.12/10,000 deliveries. Apart from the increased rate of cesarean section, OR 5.92 (95 % CI 4.12–8.40), and the risk of thrombosis, OR 5.52 (95 % CI 1.96–15.53), there was no significant increase in maternal morbidity or mortality. Prematurity, OR 2.24 (95 % CI 1.48–3.40), was the only significant newborn risk in women with malignant ovarian tumors. Newborns of women with an ovarian mass had comparable risks of intrauterine growth restriction, preterm rupture of membrane and intrauterine death.

Conclusion

The diagnosis of ovarian mass is rare during pregnancy and it is associated with an extremely low malignancy rate. Pregnant woman with a confirmed malignant ovarian tumor should be counseled regarding risks of prematurity, thrombosis and hysterectomy.

This is a preview of subscription content, access via your institution.

Fig. 1
Fig. 2

References

  1. Al-Halal H, Kezouh A, Abenhaim HA (2013) Incidence and obstetrical outcomes of cervical intraepithelial neoplasia and cervical cancer in pregnancy: a population-based study on 8.8 million births. Arch Gynecol Obstet 287(2):245–250

    Article  PubMed  Google Scholar 

  2. Smith LH, Dalrymple JL, Leiserowitz GS, Danielsen B, Gilbert WM (2001) Obstetrical deliveries associated with maternal malignancy in California, 1992 through 1997. Am J Obstet Gynecol 184(7):1504–1513

    CAS  Article  PubMed  Google Scholar 

  3. Amant F, Brepoels L, Halaska MJ, Gziri MM, Calsteren KV (2010) Gynaecologic cancer complicating pregnancy: an overview. Best Prac Res Clin Obstet Gynaecol 24(1):61–79

    Article  Google Scholar 

  4. Marret H, Lhomme C, Lecuru F, Canis M, Leveque J, Golfier F et al (2010) Guidelines for the management of ovarian cancer during pregnancy. Eur J Obstet Gynecol Reprod Biol 149(1):18–21

    Article  PubMed  Google Scholar 

  5. Leiserowitz GS, Xing G, Cress R, Brahmbhatt B, Dalrymple JL, Smith LH (2006) Adnexal masses in pregnancy: how often are they malignant? Gynecol Oncol 101(2):315–321

    Article  PubMed  Google Scholar 

  6. Aggarwal P, Kehoe S (2011) Ovarian tumours in pregnancy: a literature review. Eur J Obstet Gynecol Reprod Biol 155(2):119–124

    Article  PubMed  Google Scholar 

  7. Blake EA, Carter CM, Kashani BN, Kodama M, Mabuchi S, Yoshino K et al (2014) Feto-maternal outcomes of pregnancy complicated by ovarian sex-cord stromal tumor: a systematic review of literature. Eur J Obstet Gynecol Reprod Biol 175:1–7

    Article  PubMed  Google Scholar 

  8. Grimm D, Woelber L, Trillsch F, Keller-V Amsberg G, Mahner S (2014) Clinical management of epithelial ovarian cancer during pregnancy. Eur J Cancer (Oxf, Engl 1990) 50(5):963–971

    Article  Google Scholar 

  9. Palmer J, Vatish M, Tidy J (2009) Epithelial ovarian cancer in pregnancy: a review of the literature. BJOG Int J Obstet Gynaecol 116(4):480–491

    CAS  Article  Google Scholar 

  10. Oehler MK, Wain GV, Brand A (2003) Gynaecological malignancies in pregnancy: a review. Aust N Z J Obstet Gynaecol 43(6):414–420

    Article  PubMed  Google Scholar 

  11. Hess LW, Peaceman A, O’Brien WF, Winkel CA, Cruikshank DP, Morrison JC (1988) Adnexal mass occurring with intrauterine pregnancy: report of fifty-four patients requiring laparotomy for definitive management. Am J Obstet Gynecol 158(5):1029–1034

    CAS  Article  PubMed  Google Scholar 

  12. Yancik R (1993) Ovarian cancer. Age contrasts in incidence, histology, disease stage at diagnosis, and mortality. Cancer 71(2 Suppl):517–523

    CAS  PubMed  Google Scholar 

  13. Gezginc K, Karatayli R, Yazici F, Acar A, Celik C, Capar M (2011) Ovarian cancer during pregnancy. Int J Gynaecol Obstet Off Org Int Fed Gynaecol Obstet 115(2):140–143

    Article  Google Scholar 

  14. Van Calsteren K, Heyns L, De Smet F, Van Eycken L, Gziri MM, Van Gemert W et al (2010) Cancer during pregnancy: an analysis of 215 patients emphasizing the obstetrical and the neonatal outcomes. J Clin Oncol 28(4):683–689

    Article  PubMed  Google Scholar 

  15. Salani R, Billingsley CC, Crafton SM (2014) Cancer and pregnancy: an overview for obstetricians and gynecologists. Am J Obstet Gynecol 211(1):7–14

    Article  PubMed  Google Scholar 

  16. Timp JF, Braekkan SK, Versteeg HH, Cannegieter SC (2013) Epidemiology of cancer-associated venous thrombosis. Blood 122(10):1712–1723

    CAS  Article  PubMed  Google Scholar 

Download references

Acknowledgments

Funding was obtained from our institution.

Conflict of interest

The authors declare no conflict of interest.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Haim Arie Abenhaim.

Rights and permissions

Reprints and Permissions

About this article

Verify currency and authenticity via CrossMark

Cite this article

Nazer, A., Czuzoj-Shulman, N., Oddy, L. et al. Incidence of maternal and neonatal outcomes in pregnancies complicated by ovarian masses. Arch Gynecol Obstet 292, 1069–1074 (2015). https://doi.org/10.1007/s00404-015-3700-7

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00404-015-3700-7

Keywords

  • Cesarean section
  • Ovarian cancer
  • Ovarian mass
  • Pregnancy