Ovarian Masses in Pregnancy
Sonograms (or ultrasound) are used early in pregnancy. They are used to assess the age and health of the fetus. But during the first trimester in one to two percent of all pregnancies, a sonogram will locate a mass in the ovary area. These are rarely cancer. In fact, most resolve by the second trimester. With no symptoms or suspicious ultrasound findings, the recommendation is to repeat the test in the second trimester. Even then, only five percent of the masses that persist will be malignant.
Benign masses can cause problems. They can cause torsion (twisting). They can also rupture. Both torsion and rupture cause severe pain. They can also require emergency surgery.
To rule out malignancy, surgery may be recommended for some masses. For instance, surgery would be recommended for a mass larger than 6 centimeters. It also might be recommended if the ultrasound findings raised concern about malignancy. An MRI can be safely used during pregnancy. It might help to determine whether a mass is more likely to be malignant. But it will not provide the final answer.
A recommendation for surgery should be considered carefully. To do so, a woman and her family need to consult with the obstetrician and surgeon. If surgery is done, it should be done by a surgeon who’s familiar with ovarian cancer. The surgeon should also be able to properly stage cancer such as a gynecologic oncologistChemotherapy may be required after surgery. If so, it can be done safely in the second and third trimesters.