Tumori jajnika u trudnoći

master's thesis

• Title (english): Ovarian tumors in pregnancy
• Author: Daria Frangen
• Mentor: Berivoj Mišković (mentor)
• Committee member: Slavko Orešković (predsjednik povjerenstva)
• Committee member: Dinka Pavičić-Baldani (član povjerenstva)
• Committee member: Berivoj Mišković (član povjerenstva)
• Granter: University of Zagreb; School of Medicine; (Department of Gynecology and Obstetrics); Zagreb
• Defense date and country: 2017-07-14, Croatia
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Clinical Medical Sciences; Gynecology and Obstetrics

Abstract

Tumori jajnika u trudnoći su rijetki, a učestalost im se kreće od 0.3-5.4%. Najčešće se radi o dobroćudnim promjenama kao što su funkcionalne ciste jajnika ili benigni tumori jajnika. Većina benignih promjena u trudnoći manje su od 6 cm i obično ne predstavljaju zaprjeku normalnom vaginalnom porođaju. Dijagnozu tumora jajnika u trudnoći postavljamo na temelju fizikalnog nalaza, laboratorijskih nalaza i slikovnih metoda. Ultrazvuk je zlatni standard za dijagnozu tumora jajnika, međutim ima nisku specifičnost u procjeni maligniteta ovarijskog tumora. Zdjelična magnetska rezonancija može dodati važne dijagnostičke informacije o procjeni maligniteta i topografije tumora. Liječenje treba biti izrazito individualizirano, a ovisi o prikupljenim dijagnostičkim informacijama, sumnji na malignitet te procjeni rizika od torzije, rupture ili krvarenja. Torzija predstavlja glavnu akutnu komplikaciju tumora jajnika u trudnoći te zahtijeva hitno kirurško liječenje. Kirurške metode koje se koriste u liječenju tumora jajnika su laparotomija i laparoskopija, a odabir metode ovisi o veličini tumora , procjeni maligniteta i trajanju trudnoće. Obje kirurške metode povećavaju rizik od opstetričkih komplikacija što se prvenstveno odnosi na kasni pobačaj i rani prijevremeni porođaj. Ukoliko postoji indikacija, najbolje je kirurški tumor ukloniti oko 18. tjedna trudnoće jer je rizik za pobačaj u toj dobi relativno malen. Ukoliko je postavljena sumnja na malignitet tada se kiruršku i drugu terapiju može započeti i ranije.

Abstract (english)

Ovarian tumors in pregnancy are rare and their incidence ranges from 0.3 to 5.4%. Most commonly, they are benevolent masses such as functional ovarian cysts or benign ovarian tumors. Most benign masses in pregnancy measure less than 6 cm in diameter and usually do not represent an obstruction in labour. The diagnosis of ovarian tumors in pregnancy is based on physical findings, laboratory results and imaging methods. Ultrasound is the golden standard for the diagnosis of ovarian tumors, but it has low specificity in evaluating malignancy. Pelvic magnetic resonance can add important information on evaluation of malignancy and tumor topography. Treatment should be highly individualized, depending on the collected diagnostic information, suspicion of malignancy and estimated risk of torsion, rupture or bleeding. Torsion is the main acute complication of ovarian tumors in pregnancy and requires urgent surgical treatment. The surgical methods used are laparotomy and laparoscopy, and the choice of method depends on the size of the tumor, the estimation of malignancy and the duration of pregnancy. Both surgical methods increase the risk of obstetrical complications, such as late abortion and premature birth. If there is an indication, it is best to surgically remove the tumor at about 18 weeks of pregnancy because the risk of abortion at that time is relatively small. If there is a suspicion of malignancy then surgical and other therapy may be initiated earlier.

• Keywords: jajnik; tumor; cista; trudnoća; dijagnoza; terapija
• Keywords (english): ovary; tumor; cyst; pregnancy; diagnosis; management
• Language: croatian
• URN:NBN: urn:nbn:hr:105:656630
• Study programme: Title: Medicine; Study programme type: university; Study level: integrated undergraduate and graduate; Academic / professional title: doktor/doktorica medicine (doktor/doktorica medicine)
• Type of resource: Text
• File origin: Born digital
• Access conditions: Open access
• Created on: 2018-01-10 11:52:10