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Adnexal masses 5 cm in diameter or greater extirpated during cesarean operation
Serenat Eris Yalcin1, Yakup Yalcin2, Mehmet Ozgur Akkurt1, And Yavuz1, Mekin Sezik1 1Division of Perinatology, Faculty of Medicine, Department of Obstetrics and Gynecology, Suleyman Demirel University, Isparta, Turkey 2Division of Gynecologic Oncology, Faculty of Medicine, Department of Obstetrics and Gynecology, Suleyman Demirel University, Isparta, Turkey
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Introduction: Adnexal masses are common gynecologic problems that can affect women of all ages. They can also be found during pregnancy or as an incidental finding during cesarean section. The majority of cysts detected in early pregnancy is physiological and usually resolve without complications. Very few of these persist, and the management remains controversial.
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Introduction: The overall incidence of malignant adnexal masses in pregnancy is approximately 3%. Previous studies suggested that incidental detection of adnexal masses at cesarean section seem to rise due to the increased percentage of cesarean deliveries. The aim of our study was to evaluate the characteristics and management of adnexal masses in the course of cesarean section within a period of 10 years in a single.
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Materials and Methods We analyzed data regarding 8308 cesarean sections, and cases with adnexal masses greater than 5 cm extirpated during cesarean section in a period of 10 years ( ) were included. As our aim was to evaluate adnexal masses detected during cesarean delivery, we excluded All vaginal deliveries, Small (<5 cm) adnexal masses that were diagnosed in the first or second trimesters (< 28 weeks’ gestation) and followed up during pregnancy, Cases that had undergone adnexal surgery during pregnancy.
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Materials and Methods A total of 60 patients met the inclusion criteria. We recorded age, gravidity, parity, gestational age at surgery, operative findings, tumor histopathology, and maternal and perinatal complications from patient files. For comparison, 120 women (on a 2:1 basis) were randomly selected among remaining cesarean sections performed during the study period.
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Conclusion In our series, ovarian cystectomy was not associated with increased perioperative complications, except increased duration of cesarean operation. In our opinion, any adnexal mass that appears suspicious for malignancy and > 5 cm in size should be removed and sent for frozen section to avoid delay in diagnosis and requirement for additional surgery, If frozen section indicates malignancy, necessary advanced surgical interventions should be implemented within a single operative session by a gynecologic oncology team.
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