[Antenatal diagnosis and postnatal management of ovarian cysts]

Abstract

Introduction: Advances in perinatal sonography have brought to light the problem of ovarian cysts in the fetus and their management during pregnancy and after birth. The majority of such cysts disappear during infancy. According to most researchers, surgery is required when cyst diameter exceeds 5 cm. Complex cysts and complicated cysts also require surgical intervention.

Aim: To present an analysis of the diagnostic and surgical approach to ovarian cysts disclosed antenatally or during the first months of life and managed at the Department of Pediatric and Oncological Surgery, Pomeranian Medical University in Szczecin.

Material and methods: A retrospective study was done in 11 newborns/infants treated for an ovarian cyst in 1998-2004, including 5 with antenatal diagnosis of ovarian cyst. Circumstances and time when the decision to operate was made were studied in the context of eventual complications and risk of loss of ovary.

Results: The decision to operate in 10 newborns/infants (one cyst with a diameter of 1.86cm disappeared spontaneously in the fifth month of life) was made when cyst diameter was 4cm or greater or when the cyst was smaller but revealed mobility and sonographic signs of a complex cyst or torsion (5 cases). The diameter of cysts disclosed perinatally ranged from 2.5 to 7 cm (one of them was a chocolate cyst). The ovary was spared in eight patients.

Conclusions: Early sonographic monitoring should be undertaken in newborns with perinatal diagnosis of ovarian cyst. Because of the risk of torsion (50% of cases in the present study), surgical intervention is necessary when cyst diameter is 4 cm or greater.