Management of adnexal masses recognized incidentally during the cesarean: Our 5 years only central experience

INTRODUCTION: The objective of the study was to review our approach to adnexal masses detected incidentally during cesarean section and the data in the literature.
METHODS: This study was carried out by retrospectively scanning the files of patients who delivered by cesarean section between January 2015 and February 2020 in Süleyman Demirel University Faculty of Medicine Gynecology and Obstetrics Clinic. Patients with adnexal mass found in pre-operative examinations were excluded from the study. A total of 111 patients were included in the study.
RESULTS: January 2015–February 2020 in our hospital between 3700 cesarean deliveries was realized one of them in their 111 (3% of cesarean births); adnexal mass was detected during cesarean section. Main patient age was 32.26±6.03 (18–43) and the mean pregnancy number was 1.95±1.07 (1–6). Cephalopelvic disproportion is the most common (32.4%) cesarean indication; previous cesarean (21.6%) was followed up in the second frequency. Mean week of gestation performed by cesarean was 37.09±2.39. The mean adnexal mass size was 2.77±1.73 (1–10 cm). Fifty (45.1%) of the adnexal masses were observed in the right adnexal area, 55 (49.5%) in the left adnexal area, and 6 (5.4%) were followed them bilaterally. While cyst excision was performed in 110 patients, oophorectomy was performed in one patient. Pathology of 1 (0.9%) patient was reported as malignant.
DISCUSSION AND CONCLUSION: In pregnant women in the first trimester, obstetric ultrasonography performed routinely since both adnexal and should be examined in detail. Pelvic masses determined dimensions during cesarean section increases, whereas above 5 cm, especially torsion, hemorrhage or rupture must be removed because they have a risk of malignancy development.