Is Conservative Management of Prenatal and Neonatal Ovarian Cysts Justifiable?

Foley, Peter; Ford, W. D. A.; McEwing, Rachael L.; Furness, M. E.

doi:10.1159/000086831

Cited by 43 publications

(25 citation statements)

References 58 publications

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“…Other than the 2 mesenteric cysts, no abnormalities were observed in 4 cases. This finding correlates with the literature reporting that only one-third of ovarian cysts remain until the neonatal period [11] . Spontaneous resolution of the ovarian and mesenteric cysts is not an infrequent finding and should be kept in mind in the management.…”

Section: Discussionsupporting

confidence: 92%

Perinatal Outcomes of Fetal Abdominal Cysts and Comparison of Prenatal and Postnatal Diagnoses

Özyüncü¹,

Canpolat²,

Çiftçi³

et al. 2010

Fetal Diagn Ther

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Introduction: The differential diagnosis of an abdominal cyst can be challenging, and an accurate diagnosis is crucial for optimal antenatal management. The aim of this study was to compare the ante- and postnatal diagnoses of cases with abdominal cyst and to determine the diagnostic accuracy of ultrasonography. Material and Methods: A database review was performed regarding the diagnosis of fetal abdominal cyst covering the period 2002–2009. Structural characteristics and localizations of the cysts in the abdomen were recorded. Ante- and postnatal diagnoses were classified into systems according to the origin of the cyst and were compared. Perinatal outcomes were obtained for all cases. Results: 71 cases with an abdominal cyst were identified. The mean gestational age at the time of diagnosis was 25 ± 5.1 weeks. In 9 cases, there were extra-fetal structural abnormalities, and in 5 cases a chromosomal abnormality was determined. Seven pregnancies were terminated. Overall spontaneous mortality was 11/64 (17%). In 12/64 cases (18%), the cyst resolved at birth. After birth, nearly half of the cases required surgical correction and of these, 20% died. Sensitivity, specificity and positive predictive value of ultrasonography in identifying the system of origin were 88.1, 95.7 and 92.0%, respectively, with a 4.1% false-positive rate. Conclusion: Incorporation of different disciplines in the counseling, management and postpartum follow-up is crucial. Postnatal physical examination of fetuses with an abdominal cyst will help to prevent unnecessary surgery.

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Section: Discussionsupporting

confidence: 92%

Perinatal Outcomes of Fetal Abdominal Cysts and Comparison of Prenatal and Postnatal Diagnoses

Özyüncü¹,

Canpolat²,

Çiftçi³

et al. 2010

Fetal Diagn Ther

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“…Further long-term follow-up is required to confirm their gonad function. On the other hand, some investigators have argued that conservative treatment of asymptomatic complex neonatal ovarian cysts can be safely undertaken, avoiding unnecessary surgical intervention [13,14]. As a result, ovarian cystic torsion tends to happen in complex cysts with a size ≥40 mm at neonatal scan (table 2).…”

Section: Discussionmentioning

confidence: 99%

Postnatal Outcome in Cases of Prenatally Diagnosed Fetal Ovarian Cysts under Conservative Prenatal Management

Nakamura

Ishii²,

Murata³

et al. 2014

Fetal Diagn Ther

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Aim: To evaluate the outcome of cases of prenatally diagnosed fetal ovarian cyst under conservative prenatal management. Methods: This retrospective cohort study included patients diagnosed between January 2005 and August 2013. They were managed expectantly during pregnancy and followed up until spontaneous regression of the cyst or postnatal surgery. The outcomes of fetal ovarian cysts were compared combined appearance as being simple or complex at prenatal scan and maximum size of cysts ≥40 or <40 mm. Results: There were 33 study cases. Prenatally 3/33 cases (9%) had spontaneous cyst regression during pregnancy. 14 cysts (42%) were treated surgically, of which torsion was confirmed in 4 (29%). Another 14/33 cases (42%) regressed spontaneously under conservative management after birth. The ovaries could be preserved in 28 patients (85%). The incidence of torsion between complex cysts and simple cysts was not statistically different. The incidence of torsion between patients with cyst size ≥40 and <40 mm was similar. Conclusions: The ovaries could be preserved in approximately 85% of patients under conservative management. The present study could not reveal the significance of prenatal ultrasonographic findings of fetal ovarian cyst for predicting the outcome of patients' ovaries.

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“…Single or multiple cysts involving one or both ovaries are observed in approximately 30% of fetuses in the third trimester of pregnancy [8, 9] and in 40–80% of full-term infants in the first 2 years of life [10], although the size of such cysts in 90% of these girls does not exceed 9 mm, with an average size of 7.5 mm and an ovarian volume of 1 ml. Fifty percent of these cysts regress spontaneously in the 1st month of life, another 25% disappear by the end of the 2nd month, and approximately 10% persist after the child is more than 3 months old [11].…”

Section: Discussionmentioning

confidence: 99%

Ovarian Hyperstimulation Syndrome in Newborns – A Case Presentation and Literature Review

Starzyk

Wójcik²,

Wojtyś³

et al. 2008

Horm Res Paediatr

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Preterm ovarian hyperstimulation syndrome (POHS) is a rare condition in which immaturity of the gonadal axis is accepted as the cause. Based on our case and 8 cases from the literature, we made an attempt to specify the mechanisms underlying the syndrome and its pathognomonic signs. All POHS newborns were born between 24 and 31 weeks postconception age (WPCA) and developed vulvar, hypogastric and upper leg swelling, and ovarian follicular cyst/cysts (10–40 mm in diameter) with mildly or considerably elevated E₂ concentrations (80–5,300 pmol/l) between 35 and 39 WPCA. The GnRH test, performed in 5 cases, confirmed gonadal axis activation. In our case the observed normalization of elevated gonadotropin values by 43 WPCA, accompanied by a simultaneously increasing E₂ value (approximately 800 pmol/l), could correspond with the maturation of the gonadal steroid-dependent negative-feedback mechanism. The continuously increasing E₂ levels after this period (maximum 1,300 pmol/l) suggest its autonomous secretion. In all the cases, including 3 neonates treated with medroxyprogesterone and surgery, the swelling resolved by 6 months. Conclusions: A pathognomonic sign of POHS is swelling which develops around 37 ± 3 WPCA, and the syndrome is only infrequently diagnosed when the swelling is profound. The direct etiologic factor here is not E₂. POHS does not require therapy as long as there is no danger of cyst torsion.

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Is Conservative Management of Prenatal and Neonatal Ovarian Cysts Justifiable?

Cited by 43 publications

References 58 publications

Perinatal Outcomes of Fetal Abdominal Cysts and Comparison of Prenatal and Postnatal Diagnoses

Perinatal Outcomes of Fetal Abdominal Cysts and Comparison of Prenatal and Postnatal Diagnoses

Postnatal Outcome in Cases of Prenatally Diagnosed Fetal Ovarian Cysts under Conservative Prenatal Management

Ovarian Hyperstimulation Syndrome in Newborns – A Case Presentation and Literature Review

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