Laparoscopy for Adnexal Masses Is Safe and Effective During Pregnancy

Laparoscopy has been shown to be a safe and effective option for many diverse pelvic organ diseases, but how does the procedure fare during pregnancy? Due to the absence of large, comparative studies in pregnancy, there has been no definitive answer to this question. Now, researchers from Korea have found that laparoscopic surgeries can be safely used in women who are pregnant. Their results have been published in The Australian and New Zealand Journal of Obstetrics and Gynaecology.

Dr. Yu-Jin Koo, from the department of obstetrics and gynecology at Cheil General Hospital and Women’s Healthcare Center, Kwandong University College of Medicine, Seoul, and colleagues conducted a retrospective study of pregnant women (N=262) who underwent laparotomy or laparoscopic surgery for adnexal masses. Women in the laparoscopic surgery group (N=88) received general endotracheal anesthesia and were placed in the modified dorsolithotomy position during surgery. In contrast, women in the laparotomy group (N=174) received general or regional anesthesia; the surgeon’s preference dictated the anesthesia used. Although there were no significant differences in baseline characteristics such as mean age, body mass index, parity, history of assisted reproductive techniques, bilaterality of masses, or preoperative serum CA-125 level, Koo et al. found that patients in the laparotomy group had significantly larger mean mass size while those in the laparoscopy group had a significantly earlier mean gestational age at surgery and a significantly higher rate of undergoing emergency surgery.

Overall, Koo and colleagues found shorter operative times and shorter hospital stays in the laparoscopic group as compared to that of the patients in laparotomy group. In terms of obstetrical outcomes, Koo et al. did not find any significant difference between the groups for mean gestational age, mean birth weight, mean Apgar score, or the rates of preterm delivery, low birth weight, or miscarriage. However, the researchers found that preterm labor occurred more frequently in the laparotomy group as compared to the laparoscopy group (odds ratio= 5.85).

“The results obtained during our 10 years of experience indicate that laparoscopic surgery during pregnancy may have better surgical and similar obstetric outcomes, primarily shorter operative times and shorter lengths of hospital stay compared with those of laparotomy,” Koo and colleagues explained.
 

References:

Reference:
Koo YJ, Kim HJ, Lim KT, et al. Laparotomy versus laparoscopy for the treatment of adnexal masses during pregnancy. Aust N Z J Obstet Gynaecol. 2012; 52(1):34-38.