Efficiency of ultrasound studies in the differential diagnosis of ovarian tumors and tumoroids in pregnant women
Objective. To estimate the diagnostic value of ultrasound studies in the differential diagnosis of ovarian tumors and tumoroids in pregnant women. Subject and methods. Three hundred and forty-nine pregnant women with ovarian tumors/tumoroids were examined. Group 1 included 123 women who had undergone surgical treatment during their pregnancy at 8 to 28 weeks; Group 2 comprised 142 women in whom the tumor had been removed during cesarean section; and Group 3 consisted of 84 women who had been surgically treated 6 days to 7months after spontaneous delivery. All the patients underwent ultrasonography during their first referral for medical help, in the screening periods, in the presence of indications during pregnancy, prior to surgery, in the postoperative period, and in the presence of signs of threatened miscarriage. Ultrasonography encompassed color Doppler mapping and Doppler metry in addition to echography. All removed ovarian tumors/tumoroids were histologically verified. The data were compared to determine the diagnostic value (sensitivity and specificity) of comprehensive ultrasonography in the diagnosis of ovarian tumors/tumoroids in pregnant women. Results. The sensitivity and specificity of ultrasound studies in the diagnosis of benign epithelial tumors, including serous, seropapillary, mucinous cystadenomas were 71.4 and 94.9%, those of mature cystic teratomas were 91.7 and 98.7%, and those of endometriod cysts were 83.9 and 97.4%, respectively. The accuracy of the diagnosis of borderline and malignant ovarian tumors was highest and accounted for 90.9 and 99.1%, respectively. The diagnosis of tumoroids (paraovarian, follicular, corpus luteum, simple, lining epithelium-free, inclusion, or thecalutein cysts) showed the least accuracy (sensitivity, 76.1%; specificity, 88.1%. Conclusion. The echographic pattern of ovarian tumors/tumoroids exhibits a number of features in pregnant women. To make a decision about surgical treatment during pregnancy, ultrasonography in pregnant women with ovarian tumor/tumoroids should be of expert nature and made by the most experienced specialists in a specialized health facility where possible.