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The widespread use of ultrasound in the first trimester for dating and for viability and nuchal fold assessment has increased the detection of ovarian masses. The use of high-frequency transvaginal probes has allowed the detailed imaging of cystic pelvic masses. Cervical and ovarian cancers are the gynaecological malignancies most frequently diagnosed in pregnancy. Most non-benign ovarian cysts found in pregnancy are borderline tumours or germ cell tumours. Ultrasound imaging of ovarian cysts or masses is helpful in identifying lesions that are of a suspicious nature. A significant proportion of germ cell tumours in pregnancy are dysgerminomas. Presentation and diagnosis at an early stage of pregnancy does not always warrant termination of pregnancy as there are several reports of uneventful term pregnancies despite administration of chemotherapy. If malignancy is suspected, a full staging laparotomy is needed either immediately or after delivery.
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