1990년 1월부터 1995년 12월말까지 만 6년간 강북삼성병원 산부인과에서 경험한 임신중 합병된 난소종양 59례(양성종양 58례, 악성종양 1례)에 대한 임상적 고찰을 하여 다음과 같은 결과를 얻었다. 1. 발생빈도는 같은 기간의 총 분만수 7,649례에 대해 59례로 1:130이었고 그중 악성종양이 1례 있었다. 2. 연령은 25~29세군에서 가장 많았으며(50.8%), 다산모보다 초산모(55.9%)에서 흔히 발견되었다. 3. 초진시 주소 및 증상으로는 무증상이 38례(64.4%)로 가장 많았으며, 하복부 동통이 10례(16.9%) 하복부 종괴촉지 4례(6.8%), 질출혈 3례(5.1%) 순이었으며 요통, 오심, 구토, 소화불량 등의 증상도 있었다. 4. 진단시기는 임신 제1삼분기가 49.1%, 임신 제2삼분기가 5.1%, 임신 제3삼분기가 45.8%이었고 진단방법은 초음파와 내진으로 이루어진 경우가 28례(47.4%)였으며 제왕절개술 중 우연히 발견된 경우도 27례(45.8%)나 되었다. 5. 병리조직학적 소견으로는 양성 낭종기형종이 21례(35.6%)로 가장 많았으며 부난소 낭종이 13례 (22.0%), 장액성 낭선종이 9례(15.2%), 점액성 낭선종이 5례(8.5%), 단순낭종이 3례(5.1%), 자궁내막 낭종, 난포막 화체낭종, 황체낭종이 각각 2례(3.4%), 섬유종이 1례(1.7%)였으며 1례가 경계성 점액성 낭선암으로 1.7%를 차지하였다. 6. 종양의 크기는 6cm미만인 경우가 26례(44.1%), 6~10cm인 경우가 23례(39.0%)로 대부분을 차지하였으며 11~15cm인 경우가 7례(11.8%), 15cm이상인 경우가 3례(5.1%)로 나타났다. 7. 종양의 발생부위는 좌측이 33례(61.1%), 우측이 21례(38.9%)로 좌측이 더 많았으며 5례(8.5%)에서 양측성이었다. 이중 2례의 양성 낭성기형종, 1례의 점액성 낭선종, 1예의 부난소 낭종이 있었다. 8. 난소종양에 동반된 합병증으로는 염전이 4례(6.8%), 파열이 2례(3.4%)이었고 염전과 파열이 함께 온 경우는 1례(1.7%)있었다. 9. 수술방법은 보존적 낭종절제술이 20례(33.9%), 일측성 난소 난관절제술이 17례(28.8%), 일측성 난소 절제술이 15례(25.4%), 쐐기형 절제술이 2례(3.4%) 등의 순이었고, 수술은 임신 제3삼분기 때 제왕 절개술과 함께 시행된 경우가 7례(50.0%)로 가장 많았으며 임신 제2삼분기 때가 5례(35.7%), 제1삼 분기때가 2례(14.3%)로 나타났다. 10. 난소종양으로 인한 산과적 합병증으로는 난산 4례(6.8%), 둔위태아 1례(1.7%)가 있었고, 기타 합병증으로는 수술전 자연유산, 전치태반이 각각 3례(5.1%), 임신중독증 2례(3.4%), 조산, 태아가사 상태 등이 각각 1례(1.7%)있었다. 11. 수술후 임신의 경과를 보면 만삭까지 임신이 유지된 경우가 16례(50.0%)로써, 그중 정상분만 7례 (43.7%), 제왕절개술 9례(56.3%)이었고 수술전 자연유산 3례(9.4%), 인공유산 11례(34.4%)이었으며 수술후 자연유산된 경우는 없었다.

Ovarian tumors in pregnancy sometimes offer many problems in clinical practice. This study consists of 59 patients with ovarian tumors in pregnancy who were operated on in Kangbook Samsung Hospital between Jan. 1990 and Dec. 1995. The purpose of this study is to report the incidence, relative frequencies of different histopathologic types and operations of ovarian tumors in pregnancy. The results were as follows; 1. The incidence of ovarian tumors in pregnancy was 1 in 130 deliveries and there was one case of malignance. 2. The ovarian tumors were the most common between 25 and 29 years of age pregnant women(50.8%) and more common in nulliparous women(55.9%) than in multiparous women. 3. As to the initial chief complaints or presenting symptoms, there were no symptoms in 38 caes(64.4%), low abdominal pain in 10 cases(16.9%), palpable mass in 4 cases(6.8%) and vaginal spotting in 3 cases(5.1%). There were also symptoms of lumbago, nausea, vomiting and indigestion. 4. The diagnosis was made in the first trimester in 49.1% of the patients, in the second trimester in 5.1% and in the third trimester in 45.8% of the patients. 5. 28 cases(47.4%) were diagnosed by physical examination and ultrasonography and 27 cases(45.8%) were incidentally found during cesarean section. Known ovarian tumors were 4 cases(6.8%). 6. According to the histopathologic type, there were 21 cases(35.6%) of benign cystic teratoma, 13 cases(22.0%) of parovarian cysts, 9 cases(15.2%) of serous cystadenoma, 5 cases(8.5%) of mucinous cystadenoma, 3 cases(5.1%) of simple cyst, 2 cases(3.4%) of endometrial cyst, theca-lutein cyst, corpus luteum cyst, respectively, 1 case(1.7%) of fibroma and mucinous cystadenoma borderline maliganancy, respectively. 7. As to the size of tumor, 26 cases(44.1%) were below 6cm in diameter, 23 cases (39.0%) were 6~10cm, 7 cases(11.8%) were 11~15cm, 3 cases(5.1%) were over 15cm. 8. The left side tumor was more common being 33 cases(61.1%) and the right side was in 21 cases(38.9%). 2 cases of benign cystic teratoma, 1 case of mucinous cystadenoma, parovarian cyst and serous cystadenoma, respectively were bilateral. 9. Complications resulting from ovarian tumors occurred in 7 cases(11.9%), being 4 cases(6.8%) of torsion, 2 cases(3.4%) of rupture and 1 case(1.7%) of torsion with rupture. 10. Conservative ovarian cystectomy was performed in 20 cases(33.9%), unilateral salpingo-oophorectomy in 17 cases(28.8%), unilateral oophorectomy in 15 cases(25.4%), and ovarian wedge resection in 2 cases(3.4%). 11. Operation was performed at third trimester with cesarean section in 7 cases(50.0%), at second trimester in 5 cases(35.7%) and at first trimester in 2 cases(14.3%). 12. Associated obstetric complications were 4 cases(6.8%) of obstructed labor and 1 case of breech presentation. 13. According to outcome of pregnancy, term delivery occurred in 16 cases(50.0%), among them vaginal delivery in 7 cases(43.7%), cesarean section in 9 cases(56.3%). There were spontaneous abortion before operation in 3 cases(9.4%), artificial abortion in 11 cases (34.4%) and no spontaneous abortion after operation.