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Ovarian cancer in Pregnancy

Ovarian cysts in pregnancy

In most cases, ovarian cysts in pregnancy are not a cause for concern. Ovarian cysts are rather common in pregnancy, especially in the first half. The overwhelming majority of these cysts are innocent, the so-called "functional cysts".

If an ovarian cyst is found while performing an ultrasound scan of the pelvis in pregnancy, the features are analyzed to see if it looks suspicious. It is usually checked with a follow-up ultrasound. If it appears to be increasing in size or changing in character, an operation will be performed to remove the cyst, usually around 16 to 20 weeks of gestation.

Surgery poses little risk to the pregnancy, is technically not difficult to perform and avoids undue delay in confirming diagnosis. Small simple-looking cysts of less than 8 cm diameter do not usually merit any intervention, provided they are not growing.

Surgery to remove cysts can be done by laparoscopy (keyhole) where facilities and expertise is available.

Potential complications of an ovarian cyst in pregnancy

About one in six large ovarian cysts in pregnancy undergo torsion or twisting, which causes quite severe pain. This normally occurs in the first half of pregnancy and is rarer in advanced pregnancy. Torsion can also occur a few days after delivery.

Ovarian cancer diagnosed during pregnancy

There are different types of ovarian cancer. Action to be taken will depend on the type of ovarian cancer, the stage of the disease and the patient's wishes.

Most types of ovarian cancer can be treated adequately with surgery where the ovary and tube are removed and the pregnancy is left to continue. This is provided the disease is caught at an early stage.

If the cancer is more advanced, more extensive surgery may be required while still preserving the pregnancy. The surgery will be followed by chemotherapy which, beyond the first 15 weeks of pregnancy, is in the main considered safe for the fetus.

However, surgery itself can provoke a miscarriage.

Radiotherapy for ovarian cancer in pregnancy

There is a form of ovarian cancer - relatively common in the younger woman - which responds quite well to radiotherapy. It is called a "dysgerminoma".

The best treatment for the disease in the early stages is still surgery but, if it is more advanced, radiotherapy may be necessary for a complete cure.

If diagnosis of ovarian dysgerminoma is made in early pregnancy, the radiotherapy part of treatment may be deferred until the fetus is viable. This approach requires very careful analysis of all the factors and, of course, the mother's wishes.