Characteristics of ovarian endometrioma during pregnancy

Mio Takami, Ryoko Kajiyama, Etsuko Miyagi, Shigeru Aoki
Journal of Obstetrics and Gynaecology Research · 2021 · vol. 47(9) , pp. 3250–3256 · doi:10.1111/jog.14862 · PMID:34155737 · W3173492890
article OA: closed CC0 ⤵ 5 in-corpus citations
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⚙ AI-generated summary by claude@2026-06, 2026-06-08 ⓘ

This study found that most ovarian endometriomas decrease or disappear during pregnancy, but 2.8% rupture, with risk factors including adhesions, increased size, and compression from the uterus.

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Abstract

AIM: During pregnancy, the ovarian endometrioma generally decreases in size and occasionally ruptures. We evaluated (1) whether and how ovarian-endometrioma size changes from the first trimester to the postdelivery period, and (2) the type of endometrioma more likely to rupture during pregnancy. METHODS: During an 18-year period (2000-2018), ultrasound in the first trimester revealed ovarian endometrioma in 149 pregnant women at our tertiary institute. Among these, we subjected 138 endometriomas in 145 patients to expectant management (wait-and-watch approach during pregnancy). We compared the cyst sizes in the first trimester and the postdelivery period, and defined a >1 cm diameter size-change as a significant increase/decrease. We analyzed four patients with rupture and characterized the predictors of rupture. RESULTS: A comparison of cyst sizes in the first trimester and the postdelivery period revealed that the size of 94 (68%), 37 (27%), and 7 ovaries (5.0%), respectively, decreased, remained unchanged, and increased; in 56 ovaries (40%), apparent cysts were no longer present. Of the 145 patients, four (2.8%) required emergency surgery for cyst rupture. Adhesion to the surroundings, an increase in cyst size, large size (diameter of ≥6 cm), and compression due to the enlarged uterus in late pregnancy were factors clinically related to rupture. CONCLUSIONS: Approximately two-thirds of ovarian endometriomas decreased in size during pregnancy (40% disappeared), 27% remained unchanged, and only 5% increased in size. However, 2.8% of pregnant women with endometrial cysts experienced rupture. We characterized risk factors for rupture; however, clinical application requires further evaluation.

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Condition tags

endometriosisendometrioma

MeSH descriptors

Endometriosis Endometriosis Ovarian Cysts Ovarian Cysts Ovarian Diseases Female Humans Ovary Pregnancy Pregnancy Trimester, First Risk Factors Ultrasonography

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