Teratomas are among the common tumors in women, with ovarian teratomas being the most prevalent. They originate from germ cells in ovarian tissue and contain components such as hair, teeth, bones, and fat. 95% of teratomas are benign, but the possibility of malignancy cannot be completely ruled out. Therefore, when a teratoma is detected in early pregnancy, the first step is to determine whether it is benign or malignant. It is best to combine gynecological ultrasound reports and tumor marker tests to clarify its nature as much as possible. Those highly suspected of being malignant should undergo surgical treatment as early as possible. At this point, saving lives is the top priority, and termination of pregnancy may be necessary. If the teratoma is considered benign after examination, the next step is to evaluate its size and consider further treatment options.
If the teratoma is less than 5cm in size on ultrasound, it can be left untreated for the time being. However, regular monitoring of the teratoma's size is essential during pregnancy. If the tumor does not increase in size in the short term and there is no risk of torsion or rupture, laparoscopic surgery can be performed after delivery. For patients with teratomas larger than 5cm, treatment can be carried out during the second trimester of pregnancy. Laparoscopic surgery is often chosen between the 16th and 20th weeks of pregnancy because performing surgery too early can easily cause miscarriage, while performing it too late may affect the surgical field due to the enlarged uterus. In the second trimester, whether general anesthesia or combined spinal-epidural anesthesia is used, both are relatively safe for the fetus. In many cases, teratomas in early pregnancy may be small and asymptomatic. However, during pregnancy, some teratomas may grow rapidly due to the effects of estrogen. In such cases, it is important to take them seriously and actively adopt appropriate treatment measures. In late pregnancy, as the uterus enlarges in the pelvic cavity, ovarian teratomas may be compressed. Additionally, after delivery, the sudden emptiness of the pelvic cavity may easily induce torsion of the teratoma. In such situations, a cesarean section can be performed along with surgical removal of the teratoma.
