Abstract
The present study provides our clinical experience regarding the imaging diagnosis, management and postnatal outcome of neonates prenatally suspected of having developed ovarian cysts. This multicenter observational study included patients diagnosed prenatally with fetal ovarian cysts and follow-up in the postnatal period. Descriptive statistics were used to render the information regarding the prenatal imaging aspect of the fetal pelvic masses using ultrasound and/or MRI, prenatal surveillance and postnatal neonate’s immediate outcome, indications leading to surgery and pathologic aspect. The inclusion criteria were fulfilled by 21 patients. The mean gestational age at the time of initial diagnosis was 31.28 weeks of gestation (WG). Only five out of 21 cysts regressed completely during pregnancy without postnatal complications. In addition, 11 out of 21 infant’s required surgical treatment in the first two weeks after birth, mainly for ovarian torsion. Five out of 21 neonates were referred to postnatal follow-up clinically and by ultrasound, but three out of five cases required emergency surgical treatment for acute complications. Ultrasound plays a major role in the diagnostic of fetal ovarian cyst. From our experience, MRI does not bring supplementary data or change the management. Spontaneous resolution of fetal ovarian cysts is to be expected but the ovarian mass could lead to serious complications, if resolution does not occur in due time.
Highlights
Ovarian cysts are the most frequent type of abdominal tumor found in female fetuses or newborns [1]
In the present paper we provide an overview of our experience of fetuses with the suspicion of an antenatal ovarian cyst
The study included 19 cases of fetal ovarian cysts diagnosed prenatally in the Maternal and Fetal Medicine Department of 1st Clinic of Obstetrics and Gynecology Cluj-Napoca, and 9 patients referred to 1st Clinic of Obstetrics and Gynecology, Craiova, Emergency County Hospital, Romania
Summary
Ovarian cysts are the most frequent type of abdominal tumor found in female fetuses or newborns [1]. The most plausible cause of this condition is represented by the excessive response of the fetal ovaries to high amounts of certain gonadotrophins and estrogens found in the placenta or maternal bloodstream [3]. Considering that very high β-hCG (Human Chorionic Gonadotropin) levels are known to be associated with alterations in maternal ovarian structure, extending causality to fetal ovarian cysts is only logical [4]. Preeclampsia, and rhesus immunization are conditions frequently associated in pregnancies with ovarian fetal cyst [5]. As thyroid function can influence homeostasis leading to ovarian hyperstimulation in pregnant women, the elevated levels of TSH could mimic the effects of high β-hCG, explained by structural similarities between the above mentioned hormones and of their receptors, prompting similar complications in the fetal ovary [6]. Some authors suggest that a vascular anomaly is the underlying etiopathology behind an abnormal development of the primitive gonad [7]
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