Assessing and Managing Adnexal Masses

Target Population: Women's health clinicians

Background and Objective

As access to and quality of imaging improves, more women and their clinicians face diagnoses of adnexal masses. Now, ACOG has published updated guidelines for evaluating and managing such masses.

Key Recommendations

Ultrasound Imaging

• Vaginal ultrasound is usually appropriate for first-line evaluation of adnexal masses.

• Abdominal ultrasound should be used when the vaginal approach is not appropriate (e.g., in patients with severe genital atrophy) and for masses that extend beyond the pelvis.

• Doppler assessment of vascular flow is an important adjunct to ultrasound imaging.

• Masses >10 cm, presence o…