European Journal of Biomedical and Pharmaceutical Sciences

MATERNAL AND PERINATAL OUTCOME IN WOMEN WITH OVARIAN TUMORS COMPLICATING PREGNANCY

Riya Gupta, *Latika Sahu

ABSTRACT

Background: Ovarian tumors during pregnancy are uncommon and pose significant diagnostic and therapeutic challenges because of physiological changes associated with pregnancy and the need to optimize both maternal and fetal outcomes. While most adnexal masses are benign, timely identification of malignant lesions is essential for appropriate management. Objective: To evaluate the clinical profile, management strategies, histopathological spectrum, and maternal and neonatal outcomes of ovarian tumors diagnosed during pregnancy at a tertiary care teaching hospital. Method: This prospective observational study was conducted in the Department of Obstetrics and Gynaecology and the Gynecologic Oncology Clinic, Maulana Azad Medical College and Lok Nayak Hospital, New Delhi, from May 2023 to October 2025. Fourteen pregnant women with clinico-radiologically diagnosed ovarian tumors were included. Clinical evaluation, serum tumor markers, ultrasonography using IOTA simple rules and Risk of Malignancy Index (RMI), and magnetic resonance imaging where indicated were performed. Management was individualized according to gestational age, tumor characteristics, symptoms, and suspected malignancy. Histopathological examination was performed for surgically managed cases. Maternal, obstetric, and neonatal outcomes were analyzed. Results: The prevalence of ovarian tumors during pregnancy was 0.73 per 1,000 pregnancies. The mean maternal age was 25.7 ± 4.7 years, and 84.6% of women were nulliparous. Most tumors (84.6%) were detected incidentally during routine antenatal ultrasonography, predominantly in the first trimester. Ovarian torsion occurred in three patients (21.4%). Nine women underwent surgery, including cystectomy (66.7%) and unilateral salpingo-oophorectomy (33.3%), while five were managed conservatively with serial follow-up. Histopathology revealed predominantly benign tumors, with serous cystadenoma (28.6%) being the most common, followed by mucinous cystadenoma (21.4%). One patient was diagnosed with mucinous cystadenocarcinoma in the postpartum period. Vaginal delivery occurred in 71.4% of patients, and no adverse maternal or neonatal outcomes were observed. Conclusion: Ovarian tumors during pregnancy are rare and are predominantly benign. Early diagnosis through routine antenatal ultrasonography and individualized multidisciplinary management facilitates favorable maternal and neonatal outcomes. Surgical intervention, when indicated, can be safely performed during the second trimester or at cesarean delivery. Larger multicenter studies are needed to establish evidence-based management guidelines.

Keywords: Pregnancy; Ovarian tumor; Adnexal mass; Ovarian neoplasm; Ultrasonography; Histopathology; Maternal outcome; Neonatal outcome.