PREGNANCY COMPLICATED BY ADNEXAL MASS


This was a 28 year old lady , primi gravida , who presented with acute lower abdominal pain . Her gestational age was around 15 to 16 weeks.

Left adnexal solid mass was seen.

OVARIAN FIBROMA COMPL PREG_1

Right ovary was seen to be normal.

OVARIAN FIBROMA COMPL PREG_2

Left ovary was also seen to be normal.

OVARIAN FIBROMA COMPL PREG_3

3 D  reconstructed image of the left adnexal mass.

OVARIAN FIBROMA COMPL PREG_4

OVARIAN FIBROMA COMPL PREG_19

The pregnancy scan was otherwise normal.

OVARIAN FIBROMA COMPL PREG_6

OVARIAN FIBROMA COMPL PREG_8

The  catch for the obstetrician was that she had scanned her 2 weeks ago and found nothing abnormal. On second thoughts she was not sure whether she had scanned the adnexae after visualising the ovaries . This could be a pit fall for all of us . When we are in a hurry and when we have seen the regulation stuff organs , we might skip the in between zones . For instance while doing a whole abdominal scan , one has the chance to leave off the central zone and still give a report , where nothing was missed. But this could be a trap occasionally.

So  this patient was taken up for surgery because of the clinical presentation of  acute pain , probably torsion. The mass lesion was removed and the  pathologist reported it as PARA OVARIAN FIBROMA . The pregnancy was continued normally and was uneventful . The fetus showed mild bilateral pelvi ectasis persistently from 28 weeks onwards till delivery. Scan done 1 month after delivery showed normal kidneys in the child. 

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