Discussion

Abstract

The detection of adnexal masses in pregnancy has become increasingly more common, and therefore the dilemma of how to manage these patients has become one that is faced more frequently. In the era before ultrasound, when palpation was relied on to diagnose adnexal masses, the detection rate was reported to be 1 in 591 pregnancies. 1. Booth R.T. Ovarian tumors in pregnancy. Obstet Gynecol. 1963; 21: 189-193 PubMed Google Scholar By 1986, as ultrasound became more commonly used, the reported incidence of adnexal masses in pregnancy was 1 in 190. 2. Hogston P. Lilford R.J. Ultrasound study of ovarian cysts in pregnancy: prevalence and significance. BJOG. 1986; 93: 625-628 Crossref Scopus (71) Google Scholar Because ultrasound has become more precise over the past 15 years, that detection rate has climbed to as high as one mass detected in every 50 pregnancies. 3. Bernhard L.M. Klebba P.K. Gray D.L. Mutch D.G. Predictors of persistence of adnexal masses in pregnancy. Obstet Gynecol. 1999; 93: 585-589 Crossref PubMed Scopus (97) Google Scholar Certainly all of these lesions are not clinically significant, so we cannot say with assurance that our increased technologic capabilities have resulted in better management of patients. In fact, we may have only succeeded in raising anxiety levels. It is in addressing the question of whether what we can now detect is truly significant, and if so when, that studies such as Dr Sherard's are helpful.