Characteristics of ovarian endometrioma during pregnancy

Takami M, Mio Takami, Ryoko Kajiyama, Kajiyama R, Miyagi E, Etsuko Miyagi, Shigeru Aoki, Aoki S
Journal of Obstetrics and Gynaecology Research · 2021 · vol. 47(9) , pp. 3250–3256 · doi:10.1111/jog.14862 · PMID:34155737 · W3173492890
Observational OA: closed CC0 ⤵ 5 in-corpus citations
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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 Endometriosis Ovarian Cysts Ovarian Cysts Ovarian Cysts Ovarian Diseases Ovarian Diseases Female Female Humans Humans Ovary Ovary Pregnancy Pregnancy Pregnancy Trimester, First Pregnancy Trimester, First Risk Factors Risk Factors

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Papers in the corpus that this work cites (lower rings, blue) and that cite this one (upper rings, green). Dot size scales with the paper's in-corpus citation count — bigger dot = more influential within the endo/adeno field. Click a dot to open that paper. Outer rings show 2-hop neighbours — papers reached through the immediate citers/citees. [ collapse to 1-hop ]

References (31)

Cited by (5)

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License: CC0 · commercial use OK