P157: Prenatal diagnosis of ovarian cyst

Abstract

Fetal ovarian cysts, previously rarely reported, are being diagnosed with increasing frequency with wider utilization of obstetrical ultrasonography. The authors report a case of a 38-year-old woman, presenting in the routine sonogram at 32 weeks a fetal abdominal cyst. The ultrasonography revealed a female fetus with a rightsided thin walled multilocular cyst, separate from the stomach and bladder, measuring 5.2 × 4.3 × 4.8 cm. Amniotic fluid volume was normal. Serial sonograms obtained weekly showed no change in the size of the cyst and adequate fetal growth for gestational age. The patient was delivered by cesarean, because of a severe preeclampsia, at 37 weeks’ gestation of a 3000 g female neonate with Apgar scores of 7 and 10 at 1 and 5 minutes, respectively. The follow-up sonogram 2 weeks after birth revealed a 6 × 5.6 × 4 cm complex right adnexal cystic mass. The infant is waiting for surgery. Ovarian and genital abnormalities make up 20 per cent of all newborn abdominal masses. Fetal ovarian cysts are usually diagnosed in the third trimester as unilateral masses. Average ovarian cyst size is 5 × 5 cm at diagnosis, and size does not change throughout the pregnancy. Cesarean delivery should be reserved for obstetrical indications only, like our case. Complex masses should be operated on, and surgery must be as conservative as possible.