Adnexal Mass in Pregnancy Risk Assessment Calculator

Instructions and clinical scope

Enter gestational age, symptoms, mass size, and ultrasound morphology. The tool generates an O-RADS/IOTA-style risk impression, pregnancy-specific triage prompts, and optional Sassone morphology score. It is intended for clinical decision support and organized reporting, not as a substitute for expert ultrasound, MRI review, gynecologic oncology consultation, or local practice standards.

Pregnancy and clinical context

Gestational age, weeks

Days

Largest diameter, cm

Laterality

Symptoms

Rapid interval growth or persistent/enlarging mass

Known malignancy, metastatic disease, or very high clinical concern

Ultrasound morphology

Dominant sonographic pattern

Color Doppler score

Papillary projections

Largest solid component, mm

Locularity

Smooth wall / smooth septations

Irregular wall, irregular septations, or irregular solid tissue

Acoustic shadows present

Ascites beyond physiologic pelvic fluid

Peritoneal nodules, omental disease, or metastatic features

Known/suspected decidualized endometrioma or pregnancy-related mimic

Optional Sassone morphology score

Use for teaching morphology. Sassone is older and should not replace O-RADS/IOTA-style assessment.

Inner wall structure

Wall thickness

Septations

Echogenicity

Equations, scoring logic, and interpretation guardrails

IOTA Simple Rules-style logic

Benign features	Malignant features
Unilocular cyst; solid component <7 mm; acoustic shadows; smooth multilocular tumor <10 cm; no Doppler flow.	Irregular solid tumor; ascites; at least 4 papillary projections; irregular multilocular-solid tumor ≥10 cm; very strong Doppler flow.

If only benign features are present, the result is “IOTA benign pattern.” If only malignant features are present, the result is “IOTA malignant pattern.” If both benign and malignant features are present, or neither group is present, the result is indeterminate.

Sassone score

Sassone total = inner wall structure + wall thickness + septations + echogenicity.

Higher scores reflect greater morphologic complexity. This implementation reports the numeric score and does not use Sassone alone to determine management.

References

Andreotti RF, Timmerman D, Strachowski LM, et al. O-RADS US Risk Stratification and Management System: A Consensus Guideline from the ACR Ovarian-Adnexal Reporting and Data System Committee. Radiology. 2020;294(1):168-185.
American College of Radiology. O-RADS Ultrasound: Ovarian-Adnexal Reporting and Data System.
Timmerman D, Planchamp F, Bourne T, et al. ESGO/ISUOG/IOTA/ESGE Consensus Statement on preoperative diagnosis of ovarian tumors. Ultrasound Obstet Gynecol. 2021.
Kim J, et al. Diagnostic imaging of adnexal masses in pregnancy. J Korean Soc Radiol. 2023.
Cavaco-Gomes J, et al. Investigation and management of adnexal masses in pregnancy. Scientifica. 2016.
Sassone AM, Timor-Tritsch IE, Artner A, Westhoff C, Warren WB. Transvaginal sonographic characterization of ovarian disease. Obstet Gynecol. 1991.