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Case Reports
. 2019;46(3):166-174.
doi: 10.1159/000495506. Epub 2019 Jan 10.

Differences in Origin and Outcome of Intra-Abdominal Cysts in Male and Female Fetuses

Marjolein Husen  1 , Pauline C Schut  2 , Adriana C H Neven  1 , Nagma Yousoufi  1 , Nanko de Graaf  3 , Cornelius E J Sloots  4 , Alex J Eggink  1 , Titia E Cohen-Overbeek  1
Affiliations
Case Reports

Differences in Origin and Outcome of Intra-Abdominal Cysts in Male and Female Fetuses

Marjolein Husen et al. Fetal Diagn Ther. 2019.

Abstract

Objective: To investigate the origin and outcome in a cohort of male and female fetuses with intra-abdominal cysts, in order to provide recommendations on management and to improve prenatal counselling.

Methods: From 2002 to 2016, intra-abdominal cysts were detected by ultrasound in 158 fetuses. Cases with an umbilical vein varix were excluded. Fetal, neonatal, and maternal characteristics were retrieved from electronic patient files.

Results: In female fetuses (n = 114), intra-abdominal cysts were diagnosed at a later gestational age compared with male fetuses (n = 44) (median 32.0 vs. 21.5 weeks, p < 0.001). The maximum prenatal cyst diameter was larger in female fetuses (median 35 vs. 17 mm, p < 0.001). Associated anomalies were less frequent in females (n = 15, 13.2%) compared with males (n = 15, 34.1%). In females (n = 114), most cysts were of ovarian origin (n = 81, 71.1%). Surgery was performed in 30 (26.3%) female and 15 (34.1%) male neonates (p = 0.33). Anorectal malformations were present in 6 cases and often not recognized prenatally.

Conclusions: The differences in the origin of intra-abdominal cysts between male and female fetuses, resulting in differences in prenatal presentation and postnatal outcome should be taken into account in prenatal counseling within a multidisciplinary team. Evaluation of the fetal perianal muscular complex is indicated.

Keywords: Anorectal malformation; Fetal gender; Intra-abdominal cyst; Ovarian cyst.

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Conflict of interest statement

The authors have no conflicts of interest to disclose. This study was undertaken without the support of funding.

Figures

Fig. 1
Fig. 1
The outcome of female fetuses diagnosed with an intra-abdominal cyst in the second and third trimester. TOP, termination of pregnancy; NND, neonatal death; ARM, anorectal malformation; GI, gastrointestinal; MCDK, multicystic dysplastic kidney; MCA, multiple congenital abnormalities.
Fig. 2
Fig. 2
The outcome of male fetuses diagnosed with an intra-abdominal cyst in the second and third trimester. NND, neonatal death; IUFD, intrauterine fetal death; ARM, anorectal malformation; GI, gastrointestinal.
Fig. 3
Fig. 3
The distribution of postnatal diagnoses according to gestational age at diagnosis in female fetuses.
Fig. 4
Fig. 4
The distribution of postnatal diagnoses according to gestational age at diagnosis in male fetuses.
See this image and copyright information in PMC

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