妊娠合并卵巢肿瘤82例诊治体会

目的探讨妊娠合并卵巢肿瘤的临床特征及对妊娠结局的影响。方法对2003年1月至2005年12月上海市第一妇婴保健院收治的82例经手术及病理诊断的妊娠合并卵巢肿瘤患者的临床资料进行回顾性分析。结果妊娠期卵巢良性肿瘤80例,占97.56%,以生殖细胞肿瘤为多见,透明细胞癌1例,黏液性囊腺瘤交界型1例;孕早期超声诊断病例14例,占孕期发现的总例数的48.28%;有8例出现并发症并行急诊手术,扭转5例,破裂3例,有11例术前行血CA125检查,升高7例,其中1例为黏液性囊腺瘤交界型;足月分娩78例,占95.12%。结论超声检查在诊断及监测妊娠期卵巢肿瘤具有重要的指导意义,适时的手术干预并不影响妊娠结局,血清CA125检查在妊娠期卵巢良恶性肿瘤鉴别的意义有待进一步探讨研究。

Diagnosis, detection and treatment of ovarian tumor during pregnancy

Objective To explore ovarian tumor's characteristics,diagnosis,monitoring,treatment as well as its prognosis during pregnancy.Methods A retrospective analysis of 82 cases of ovarian tumor during pregnancy,which were treated,operated and pathologically conducted in Shanghai First Maternity and Infant Health Hospital from January,2003 to December,2005,was carried out.Results About 97.56% of the 80 cases were diagnosed as benign tumors,majority of which were demoid cysts.For the other 2 cases,one was clear cell tumor and the other was borderline mucinous cystadenoma.Fourteen cases were diagnosed by ultrasound examination during the first trimester(48.28%).Among 8 urgent operations,5 of them were caused by torsion,three by rupture.Serum samples for CA125 estimation were obtained from 11 patients prior to their operations.As a result,7 cases were elevated,one of which was borderline mucinous cystadenoma.As high as 95.12% of the cases reached to term.Conclusion Ultrasound characteristics are of principal importance in the diagnosis and detection of ovarian tumor during pregnancy.Suitable surgery intervention does not influence the outcome of the pregnancy.The ability of CA125 levels value in distinguishing benign from malignant disease remains uncertain and needs to be further studied.