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Clinical and Experimental Obstetrics & Gynecology  2020, Vol. 47 Issue (4): 537-540    DOI: 10.31083/j.ceog.2020.04.4438
Original Research Previous articles | Next articles
Prophylactic laparoscopic adnexal surgery with low-pressure CO2 insufflation for ovarian cysts during the late first trimester or second trimester of pregnancy
K. Chikazawa1, *(), K. Imai1, T. Kuwata1, K. Takagi1
1Perinatal Center, Division of Maternal Fetal Medicine, Saitama Medical Center, Jichi Medical University, Saitama 330-8503, Japan
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Abstract  

The current guidelines for endoscopic management do not contraindicate laparoscopic surgery in pregnant women; a few studies have reported on this, particularly in Japan. We aimed to evaluate the feasibility of prophylactic laparoscopic adnexal surgery during the late first trimester and second trimester for the prevention of adnexal torsion. We retrospectively reviewed eight patients who underwent laparoscopic surgery for ovarian cysts during the late first trimester or second trimester (April 2012-September 2016). The general protocol of laparoscopically-assisted cystectomy was adopted, with low-pressure CO2 insufflation (8 mmHg). No complications were noted. Five women delivered; four delivered at term and one delivered preterm owing to premature membrane rupture. Pregnancy is ongoing in the remaining three women. Prophylactic laparoscopic adnexal surgery is safe and feasible for adnexal torsion prevention in women with ovarian cysts during the late first trimester or second trimester.

Key words:  Adnexal disease      Insufflation      Pregnancy     
Submitted:  20 July 2017      Accepted:  08 November 2017      Published:  15 August 2020     
*Corresponding Author(s):  K. Chikazawa     E-mail:  kendokenro@hotmail.com

Cite this article: 

K. Chikazawa, K. Imai, T. Kuwata, K. Takagi. Prophylactic laparoscopic adnexal surgery with low-pressure CO2 insufflation for ovarian cysts during the late first trimester or second trimester of pregnancy. Clinical and Experimental Obstetrics & Gynecology, 2020, 47(4): 537-540.

URL: 

https://ceog.imrpress.com/EN/10.31083/j.ceog.2020.04.4438     OR     https://ceog.imrpress.com/EN/Y2020/V47/I4/537

Table 1  — Overview of the clinical and operative details of eight women who underwent laparoscopic adnexal surgery for ovarian cysts during the late first trimester and second trimester.
Range Mean Standard deviation
Age at surgery (years) 26-37 32.1 4.0
Body mass index (kg/m2) 17.6-25.9 20.9 7.6
Gravida status 0-2 0.38 0.48
Parity 0-1 0.38 0.48
Gestational week at time of surgery 12-16 13.4 1.4
Anesthesia time (min) 107-150 124.6 15.3
Operation time (min) 60-98 76.8 14.2
Bleeding (g) ≤ 20 3.75 6.96
Hospital stay (days) 6-8 7.4 0.7
Table 2  — Clinical and operative details of women who underwent laparoscopic adnexal surgery for ovarian cysts during the late first trimester and second trimester.
Patient designation Type of surgery? Gestational age? of the fetus Number of trocars Drainage tube Pathology Cyst size (mm) Complications
Patient 1 TLC 16w6d 3 1 Lutein 86 None
Patient 2 LAC 14w1d 3 0 Dermoid 90 None
Patient 3 LAC 12w2d 3 1 Dermoid 74 None
Patient 4 LAC 13w5d 3 1 Dermoid 62 None
Patient 5 LAC 15w1d 3 1 Dermoid 60 None
Patient 6 LAC 12w1d 2 0 Dermoid 80 None
Patient 7 LAC 13w0d 2 1 Dermoid 65 None
Patient 8 LAC 12w6d 2 0 Dermoid 64 None
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