CURRENT STATE OF THE ISSUE OF BENIGN OVARIAN TUMORS DURING PREGNANCY (LITERATURE REVIEW)

The majority of guidelines, clinical protocols and methodological recommendations deal with the treatment of tumors of uterine appendages beyond pregnancy, and the guidelines regarding pregnant women remain poorly systemized and vague, although the necessity of taking into consideration the consequences for the mother and the fetus makes the process of treat-ment of such tumors more complicated. The management of tumors of appendages detected during pregnancy is controversial. The majority of tumors of appendages are accidental findings of routine examinations of pregnancy. According to various estimations, the prevalence of neoplasms of appendages during pregnancy ranges from 0.19 to 8.8%. Most of the cases are diagnosed in the first trimester and the incidence gradually decreases as the pregnancy proceeds: 1st trimester – from 21.4 to 75.7%; 2nd trimester –from 10.9 to 44.4%; 3rd trimester – from 4 to 22.2%; after labor – from 0 to 7.1%. The majority of ovarian tumors during pregnancy are benign tumors predominantly represented by functional cysts (follicular cyst, corpus luteum cyst and lutein cyst), teratomas and cystadenomas. Any gynecological pathology in women is more or less associated with psychological stress, changes in the psycho-emotional condition that, in case of long-lasting stress exposure, may lead to psychosomatic pathology. Besides, from a psychosocial point of view, pregnancy may be regarded as a specific extremely emotional condition that may be a powerful stressor. Perinatal stress of the mother may lead to various complications that may have long-term consequences for both the somatic and the mental functioning of the newborn. The would-be mothers traditionally present a high level of anxiety and depressive disorders and many of them are susceptible to various stress factors during pregnancy. Scientific literature includes large number of publications on the issue of “ovarian tumors and pregnancy”; however, the majority of them deal with gynecological aspects, the risk of malignization, the differential diagnosis and treatment of such neoplasms only in terms of the choice between conservative treatment and surgical treatment and determining the time and the extent of a surgery. In spite of the empirical evidence of numerous consequences related to a high level of stress and the problems of mental health during pregnancy, the assessment of psychosocial stress in pregnant women is seldom carried out. Although there are some few researches on the influence of stress and a pregnant woman's psycho-emotional condition on the level of obstetric and perinatal complications, we have not found publications on similar research of pregnant women with ovarian tumors. Therefore, one of the objective of our research is to assess the influence of stress and psycho-emotional disorders on the course of pregnancy and childbirth in women with ovarian tumors and to suggest the corresponding methods of correction. Although the majority of authors admit the increased risk of obstetric and perinatal complications in women with ovarian tumors, most of all, in terms of threat of miscarriage and preterm labor, the research of this issue are poorly systemized, controversial and fragmentary, lacking research of the risk factors of such complications and of the ways to prognosticate and prevent them.