Objective To explore the clinical characteristics, treatments, and pregnancy outcomes of pregnant women with malignant ovarian tumors.

Methods We retrospectively analyzed the clinical data of 11 patients with pregnancies complicated by malignant ovarian tumors, including the pathological types, clinical staging, surgical methods, pregnancy outcomes, and follow-up results from January 2012 to December 2022.

Results Among the eleven patients followed up until October 2023, six had primary ovarian tumors and five had metastatic ovarian tumors. Among the six primary ovarian tumors, five were epithelial tumors (one in stage ⅠA, two in stage ⅠC, one in stage ⅢA, one in stage ⅡB) and one was a malignant germ cell tumor (stage ⅠA). Four patients were diagnosed at stage Ⅰ: one in early pregnancy who continued the pregnancy and underwent tumor surgery post-delivery, and three in late pregnancy who under went tumor surgery during cesarean section or postpartum. Two patients were diagnosed at stage Ⅲ: one in early pregnancy with surgery after the termination of pregnancy, and one in late pregnancy with surgery during a cesarean section. Five patients had successful births, including two premature and three full-term births, all alive and healthy. The six patients with primary ovarian tumors were followed up for 18–133 months, and all survived. Five patients had ovarian metastatic tumors, including four cases of Krukenberg tumors and one of a cervical tumor. Two patients were diagnosed in the first trimester and underwent tumor reduction post-abortion. One patient was diagnosed in the second trimester, had to continue the pregnancy, and underwent tumor reduction post-delivery. Two patients were diagnosed in the third trimester: one underwent cesarean section and ovarian tumor resection simultaneously, and the other underwent tumor resection post-delivery. Three patients had successful births, all premature but alive. One of the five patients with ovarian metastatic tumors was lost to follow-up; the remaining four were followed up for 3–22 months, and all deceased.

Conclusions The prognosis for patients with pregnancies complicated by ovarian primary tumors is favorable, whereas the prognosis for patients with pregnancies complicated by ovarian metastatic tumors is poor, necessitating greater clinical attention.