Long‐term follow‐up of children with ovarian cysts diagnosed prenatally

Abstract

Objective To assess long-term outcomes of children who had ovarian cysts diagnosed prenatally. MethodsWe reviewed prenatal records of fetuses diagnosed with ovarian cysts in our ultrasound unit children were invited to our institute for transabdominal pelvic sonographic re-examination. Demonstration of the uterus and adnexa was required.Results Twenty-one children were diagnosed prenatally with either simple (n = 11) or complex (n = 12) ovarian cysts and treated by either conservative management (n = 13) or surgical intervention (n = 10) postnatally. The ipsilateral ovary was not detected in 8 of 11 children in whom a complex cyst had been detected on the first postnatal scan. Significantly higher rate of ovarian loss was diagnosed when the sonographic appearance of the ovarian cyst was simple on the prenatal scan and complex on the postnatal scan (six of seven) compared with when the ovarian cyst was simple on both scans (one of four, P = 0.04). ConclusionPrenatal detection of complex ovarian cyst might indicate close monitoring in order to alert the need for early intervention for preventing impending ovarian loss. Further researches are needed to empower this study.

Conservative Management of a Large Neonatal Ovarian Cyst: A Case Report

“…Ben-Ami et al, reviewed records of 23 children diagnosed prenatally with NOC, treated by either conservative management (n = 13) or surgical intervention (n = 10) postnatally. The ipsilateral ovary was not detected in eight of 10 children in complex cysts managed surgically [13].…”

Complex Fetal Ovarian Cyst

“…Complex cysts that have spontaneously disappeared on sonography may have undergone involution or may be cysts that underwent initial torsion and subsequent spontaneous detorsion 6 . The mechanism that accounts for the sonographic disappearance may also be ischemic necrosis and self‐amputation of the ovary, with its consequent location in an ectopic seat and possible adhesion to other organs 5 , 9 …”

“…The time elapsed since the appearance of sonographic signs of intracystic hemorrhage is important because when it is longer than 1 or even 2 weeks, there is a considerable possibility that the ovaries are no longer functional 5 , 6 . In this case, surgery is unnecessary, but it is essential that the child be monitored both clinically and sonographically to detect any ovarian tumor or intestinal occlusion or perforation due to adhesion of the necrotic tissue to the bowel 5 , 6 . Intervention is required only after months or years of an incompletely resolved mass or persistence of a calcified structure 6 , 8 , 9 .…”

“…Intervention is required only after months or years of an incompletely resolved mass or persistence of a calcified structure 6 , 8 , 9 . Induction of birth to save the ovary should only be considered within the first week after the appearance of hemorrhage when the cysts are bilateral and after lung maturity is attained 3 , 5 , 6 …”

“…3,4 Hemorrhagic cysts are associated with torsion in 25% to 89% of cases. [4][5][6][7] There is a consensus as to the conservative approach, with sonographic monitoring to be adopted during the management of fetal or neonatal simple ovarian cysts, because most them regress spontaneously prenatally or within some period after birth. 4,6 Prenatal and postnatal management of complex ovarian cysts is still controversial.…”