<i>In‐utero</i> aspiration <i>vs</i> expectant management of anechoic fetal ovarian cysts: open randomized controlled trial

Diguisto, Caroline; Winer, Norbert; Benoist, G.; Laurichesse‐Delmas, H.; Potin, J.; Binet, A.; Lardy, H.; Morel, Baptiste; Perrotin, Franck

doi:10.1002/uog.18973

Cited by 26 publications

(24 citation statements)

References 15 publications

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“…Fetal cyst aspiration has been described in the management of larger presumed ovarian cysts, though the benefits of this intervention have not been proven (45,46). In cases where the cyst causes bowel or other organ compression leading to potential obstruction and polyhydramnios the rationale seems greater, but these are exceptional cases.…”

Section: Ovarian Cystmentioning

confidence: 99%

Fetal abdominal tumors and cysts

Cass

2021

Transl Pediatr

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This article reviews the contemporary diagnosis and management of the most common abdominal neoplasms and cystic lesions diagnosed in the fetus. Fetal tumors discussed include teratomas (sacrococcygeal, cervical or mediastinal), mesoblastic nephroma, nephroblastoma (Wilms' tumor), neuroblastoma, and hepatoblastoma. Fetal abdominal cystic lesions discussed include ovarian cyst, choledochal cyst, intestinal duplication cyst, mesenteric cyst, simple hepatic cyst, and meconium pseudocyst.We discuss the rare indications for fetal intervention or fetal surgery and other perinatal management, including prenatal interventions and fetal surgery for sacrococcygeal teratoma. The lesions reviewed are detected by widespread use of screening ultrasonography during pregnancy. Work-up for these abnormalities may include fetal MRI which enhances the diagnostic accuracy of abdominal tumors and cystic lesions and can aid in characterization of the lesion in relationship to surrounding anatomic structures. Accurate prenatal diagnosis of such lesions permits recommendations for optimal location and timing of delivery, and inclusion of appropriate caregivers and expertise to facilitate postnatal management. Perinatal management of the fetus with a neoplasm requires consideration of the optimal timing and mode of delivery, and pediatric oncology and surgical specialty care. The majority of tumors diagnosed antenatally have good prognosis with current multimodality treatment.

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Section: Ovarian Cystmentioning

confidence: 99%

Fetal abdominal tumors and cysts

Cass

2021

Transl Pediatr

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“…The available management options following diagnosis of prenatal ovarian cyst mainly involve a conservative approach requiring frequent sonographic surveillance and ultrasound‐guided prenatal cyst aspiration, in an attempt to prevent these complications 12 . The first randomized trial by Diguisto et al 13 compared these two approaches, and ultimately supported the efficacy and safety of intrauterine aspiration, especially in larger cysts measuring above 40 mm. In our case, these acute complications occurred 10 days following delivery, which also led us to wonder whether an iatrogenic preterm delivery should be considered to be part of the management of similar future cases in order to avoid fetal demise.…”

Section: Discussionmentioning

confidence: 99%

Case of fetal ovarian juvenile granulosa cell tumor: Complications and management

David

Sela

David

et al. 2021

J of Obstet and Gynaecol

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A prenatal ovarian juvenile granulosa cell tumor (JGCT) is a rare entity which may present as an intra‐abdominal cyst. Due to its low incidence, optimal management and timing for intervention remain uncertain. This report presents a case of an intra‐abdominal cystic structure in a female fetus, one of the two fetuses in a dichorionic‐diamniotic twin pregnancy, detected during routine fetal sonographic surveillance at 30 weeks of gestation. Further fetal evaluation detected the sonographic triad of an ovarian cystic mass, polyhydramnios and signs of fetal virilizations, requiring us to consider the presence of an atypical, ovarian androgen secreting tumor. Following delivery, acute ovarian torsion and intracystic hemorrhage required emergent surgical intervention, confirming the diagnosis of JGCT. Following surgical treatment, laboratory, clinical, and morphological features improved progressively.

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“…11 There are studies also which recommend aspiration of cysts in the neonatal period. 12 Considering the low morbidity associated with intrauterine aspiration (IUA) of the ovarian cysts and the reduced rate of oophorectomy among the neonates in the IUA group, systematic IUA might well be worthwhile. 12 However, one cannot completely rule out neoplastic tumours, hence aspiration needs further systematic trials.…”

Section: Discussionmentioning

confidence: 99%