Supervisors info:
Σταύρος Σοφοκλής, Επίκουρος Καθηγητής, Ιατρική Σχολή, ΕΚΠΑ
Δρακάκης Πέτρος, Ομότιμος Καθηγητής, Ιατρική Σχολή, ΕΚΠΑ
Ζηκόπουλος Αθανάσιος, Εντεταλμένος Διδάσκων, Ιατρική Σχολή, ΕΚΠΑ
Summary:
The thesis examines ovarian tumors during pregnancy, a rare yet significant clinical condition that presents challenges in both diagnosis and treatment. Ovarian tumors identified during pregnancy can be either benign or malignant, and their diagnosis is often complicated by the physiological changes occurring in the pregnant body. The presence of such a tumor can affect both maternal health and fetal development, necessitating a personalized approach to case management.
Diagnosis of Ovarian Tumors in Pregnancy
Diagnosing ovarian tumors during pregnancy requires special attention due to the physiological, hormonal, and anatomical changes that can obscure symptoms or complicate the diagnostic process. The use of non-invasive techniques is critical to ensuring the safety of both the fetus and the mother.
The primary diagnostic methods include ultrasonography and magnetic resonance imaging (MRI). Ultrasonography serves as the first-line diagnostic tool, offering detailed insights into the nature of the tumor (e.g., solid or cystic). MRI is useful in distinguishing benign from malignant tumors without the use of ionizing radiation, which could harm the fetus. Computed tomography (CT) is avoided unless absolutely necessary due to the risks associated with radiation exposure.
In addition to imaging, laboratory tests such as measuring serum tumor markers (e.g., CA-125) can be used with caution, as normal values may vary during pregnancy, potentially affecting reliability.
Treatment of Ovarian Tumors in Pregnancy
Treatment depends on the nature of the tumor (benign or malignant), the stage of pregnancy, and the overall condition of the pregnant woman. The primary goals of treatment are to ensure maternal health, protect the fetus, and, if possible, allow the pregnancy to progress to term.
Benign Tumors:
For small tumors that do not cause symptoms or complications, management is often conservative, with regular monitoring through ultrasonography.
If the tumors grow or cause complications (e.g., rupture or torsion), surgical removal may be necessary.
Malignant Tumors:
Surgical intervention can be safely performed during the second trimester when risks to the fetus are minimized. Interventions in the first trimester increase the risk of miscarriage, while third-trimester surgeries may need to be delayed until fetal maturity.
In advanced cases requiring chemotherapy, it can be administered under specific conditions from the second trimester onward to minimize fetal exposure. Chemotherapy protocols are carefully selected to avoid toxicity.
Challenges and Modern Trends
Ovarian tumors during pregnancy represent a multidimensional clinical condition requiring an interdisciplinary approach. Collaboration among obstetricians, gynecologists, oncologists, radiologists, and other specialists is crucial for effective management. Advances in diagnostic technology and understanding tumor biology enable personalized care.
Additionally, there is an increasing emphasis on educating medical professionals about contemporary guidelines for managing tumors during pregnancy. Techniques such as non-invasive ultrasonography and specialized therapeutic protocols allow safer and more effective interventions.
Conclusions
Ovarian tumors during pregnancy are a complex clinical challenge requiring careful diagnosis and individualized treatment. Modern diagnostic methods, combined with interdisciplinary collaboration, enable effective management, ensuring maternal health and fetal development. However, there remains a need for further research and improved therapeutic strategies to achieve better prognosis and quality of life for women facing this challenge.
Keywords:
Οvarian tumors, Pregnancy, Diagnosis, Treatment, Ultrasound, MRI, Surgery, Chemotherapy, Malignancy, Hormonal changes
