Adnexal surgery in pregnancy.

Adnexal pathology is a rare event in pregnancy, occurring once in 556 deliveries in this study period, during which 23 patients underwent surgery for it. Eleven patients in the first two trimesters received perioperative prophylactic progesterone without a pregnancy loss. Two of three patients beyond 20 weeks required tocolytic therapy for apparent premature labor. Dermoid cysts and torsion of a corpus luteum cyst were the most common pathologic findings. The type of incision employed was based on uterine size and expected location of the adnexal pathology. It appears that the risk to the pregnant patient undergoing adnexal surgery can be minimized with judicious timing of the operation, preoperative incision planning and modern anesthetic techniques. The use of prophylactic progesterone is unproven, and further studies of this therapeutic modality should be undertaken.