A 20 year young female presented for antenatal checkup. She was in 1st trimester and was diagnosed to have ovarian cyst. Treatment of choice:
(A) Surgical removal in IInd trimester (B) Removal after delivery (C) Termination of pregnancy and cyst removal (D) Observation
(A) Patient is presenting in the first trimester with ovarian cyst.
The principle of treatment in case of ovarian tumour is to remove the tumour as soon as the diagnosis is made. But this principle should not be followed in the first trimester.
Surgery in the first trimester is best avoided, as during surgery a corpus luteal cyst or ovary might be removed which will be detrimental to the pregnancy, which may end up in a miscarriage.
Therefore, all such cases should be operated (ovariotomy/cystectomy) in the second trimester.
Therefore, the best time of elective operation for an ovarian tumor in pregnancy is between 14 to 18 weeks, as the chances of abortion are less and access to the pedicle is easy.