Congenital Ovarian Cyst: Diagnosis and Perinatal Management

Affiliation

¹Department of Obstetrics and Gynecology, Hospital General Gregorio Maranon, Universidad Complutense de Madrid, Spain
²Department of Obstetrics and Gynecology, Hospital Central de la Defensa Gomez Ulla, Universidad de Alcala de Henares. Madrid, Spain

Abstract

Objective: To describe prenatal and postnatal outcomes of ultrasonographically diagnosed fetal ovarian cysts (FOC) and to review the literature to propose an obstetric management algorithm.
Methods: We performed a retrospective analysis of fetuses with an ultrasound-based diagnosis of FOC. The size, location, and ultrasound features of the cysts were recorded. Follow-up and treatment modalities are described.
Results: 13 of 16 had follow-up data. Almost all cases were diagnosed in the third trimester. FOC was mostly unilateral, with a mean diameter of 40.4 mm. The cysts were classified as simple in 12 cases (75%). Eleven cases (68.7%) remained stable, and 2 resolved spontaneously (12.5%) during pregnancy. No associated anomalies or chromosomal abnormalities were found. Postnatal management was surgical in 50% of cases, with laparoscopy as the main procedure. Cystectomy and alpingo-oophorectomy were performed in 4 infants each.
Conclusions: FOC is frequently isolated. Prognosis is generally good. Regular ultra-sound is necessary before and after birth to detect complications that could endanger the ovarian parenchyma. Conservative management is recommended in simple cysts under 4cm, and surgical procedures can be performed in larger simple cysts or when complications are suspected. Tissue-sparing surgery is preferable.