Course of labor and condition of the newborn in women affected by benign ovarian tumors

Abstract

Annotation. According to various estimations, the incidence of adnexal neoplasms during pregnancy makes up from 0.19% to 8.8%. Most of cases are diagnosed in the first trimester and their incidence gradually decreases as the period of pregnancy grows. Depending on their size and location, ovarian tumors may be related to an adverse obstetrical result caused by mechanical influence. They increase the risk of abortion (from 0 to 6%), preterm labor (from 5.8% to 10.4%) and mechanical impediment to labor. Aim – studying the peculiarities of the course of labor and the condition of the newborn of women affected by benign ovarian tumors. We have conducted a complex examination of 67 pregnant women with benign ovarian tumors and tumor-like growths found before pregnancy or in the first trimester of gestation (basic group) and 50 women presenting no ovarian neoplasms or any other severe gynecological or somatic pathology (reference group). To identify the risk factors, the basic group was divided into 2 subgroups. The condition of fetuses was assessed with the use of automated cardiotocography analysis based on the Dawes/Redman criteria, with the calculation of the short-term variability (STV). The mean and standard deviation (M ± m) were evaluated at a significance level of p <0.05. Categorical variables are presented as the absolute number of cases in the group and the frequency in percent – n (%). Tests for differences between independent samples in the case of quantitative variables were performed using Student’s t test, the Mann-Whitney rank test, and in the case of categorical variables using Fisher’s exact test. The obtained results suggest that the course of labor in women affected by benign ovarian neoplasms is characterized by an increased incidence of complications. A significant difference has been established in the incidence of cesarean sections (35.8% vs 8.0% in the reference group, р<0.05), preterm labor (28.4% vs. 6.0%, р<0.05), fetal distress (19.4% vs. 8.0%, р<0.05) and preterm rupture of membranes (17.9% vs. 6.0%, р<0.05). The incidence of almost all complications of labor in Subgroup 1 significantly exceeds the figures from the reference group and the incidence of preterm labor and fetal distress is also higher in comparison with Subgroup 2. The presence of extragenital pathology is a well-known risk factor for perinatal complications, which is also confirmed by our research. A high level of comorbidity of benign ovarian neoplasms with various extragenital diseases also accounts to a certain degree for gestational complications. Thus, pregnancy in women affected by ovarian tumors implies an increased risk of obstetrical and perinatal complications, in particular, threats of miscarriage and preterm labor. The studies of this issue lack systematization, are often controversial and fragmentary. There has been practically no research on the risk factors for such complications and the ways of their prognostication and prevention.