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

Abstract

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.

Fetal intra-abdominal kistlerin prenatal tanı ve perinatal sonuçları

“…Accordingly, Özyüncü et al reported overall spontaneous mortality rate to be 11/64 (17%). Intrauterine deaths in our series were 2/17 (11.8%), while this was found to be 3.6% and 4.2% in previous reports, respectively (1,21). We think this difference arises from the inclusion criteria of the study groups.…”

“…The most common antenatal diagnosis was ovarian cyst. Ovarian cyst cases were diagnosed at an average of 30.13±5.59 [20][21][22][23][24][25][26][27][28][29][30][31][32][33][34][35][36] gestational weeks. Diagnosis was confirmed as ovarian cyst at 6 of the 8 cases postnatally.…”

Prenatal diagnosis of intra‐abdominal cystic lesions by fetal ultrasonography: diagnostic agreement between prenatal and postnatal diagnosis

“…Although it has been reported that a specific diagnosis does not influence the management of patients with cystic lesions, in our study, all cases that remained undiagnosed after birth did not have a specific prenatal diagnosis. In literature, it has been reported that 17% to 24% of fetal abdominal cysts may resolve during intrauterine life and these data might be considered for a correct management and counseling. In a similar series, Ozyuncu et al reported a spontaneous resolution in 12 of 71 cases (16.9%: duodenal atresia in one, mesenteric cyst in one, ovarian cyst in four, megacystis in two, renal cyst in two, hepatic cyst in two and choledochal cyst in one).…”

“…In literature, it has been reported that 17% to 24% of fetal abdominal cysts may resolve during intrauterine life and these data might be considered for a correct management and counseling. In a similar series, Ozyuncu et al reported a spontaneous resolution in 12 of 71 cases (16.9%: duodenal atresia in one, mesenteric cyst in one, ovarian cyst in four, megacystis in two, renal cyst in two, hepatic cyst in two and choledochal cyst in one). In our series, spontaneous resolution during pregnancy occurred in 5.5% of cases (two hepatic and two ovarian cysts).…”

Twisted intra-abdominal cyst in a neonate: a surprise revelation

“…Prediction of the neonatal course is impossible as it varies from complete resolution to life-threatening complications 1. Common cysts include those arising from the gastrointestinal tract and the genitourinary tract 2. Cysts arising from the testis is a difficult diagnosis to make both prenatally and postnatally.…”