A review of surgically managed complicated ovarian cysts in pregnancy in a Northern Nigerian tertiary hospital

Abstract

Ovarian cysts in pregnancy are usually managed conservatively but surgical treatment is done for complicated cases. The diagnosis of complicated ovarian cyst in pregnancy is challenging, management often poses a dilemma to the obstetrician and is a source of anxiety to the patient because it can be associated with adverse pregnancy outcome. Complicated ovarian cysts in pregnancy accounted for 16.7% of all surgically managed ovarian cyst accidents (3/18) in our institution. It was also the most common indication for non-pregnancy-related laparotomy in pregnancy (3/6). The mean age of the patients was 31 ± 5.6 years, 66.7% (2/3) were primigravidae and all had cyst complication in the second trimester. All women presented with abdominal pain but accurate initial preoperative diagnosis was made in only 33.3%. Mean presentation to surgery interval was 46.7 h. All patients received tocolytic argents. The mean size of the cyst was 10.9 cm, commonest complication was torsion, and all cysts were benign. The commonest surgery performed was salpingo-oophorectomy. Surgical intervention was associated with favorable perinatal outcome in most cases with fetal loss seen when cyst was rapidly increasing in size or ≥15 cm in size. Prompt diagnosis and intervention enables preservation of affected adnexa.