Ovarian Cysts In Pregnancy Research Articles

Approaches to the management of ovarian cysts in pregnancy: A case series

Background: The incidence of ovarian cysts in pregnancy is postulated to be approximately 3%. Most ofthese cysts are benign, with 6% of them being benign. Most of these masses are diagnosed incidentallyduring routine ultrasound. The most common are functional cysts. Most of these cysts do not havesymptoms and are managed conservatively. For persistent symptomatic cysts, medical and surgicalmanagement is a viable option.Case series: We present cases of three patients, two of whom were managed conservatively. One of thepatients with a corpus luteum cyst was managed surgically and did well, whereas the other two patientswere noted to have asymptomatic dermoid cysts. Pregnancy outcomes for the two who delivered wereunaffected, including their modes of delivery.Conclusion: Adnexal masses are common during pregnancy. There is a need to evaluate andcharacterize these masses even during pregnancy. Management options for adnexal masses areprimarily conservative, but for masses that meet the criteria for surgical management, surgery is safe,especially in the second trimester. A laparoscopic approach for abdominal surgery in the second trimesteris feasible and relatively safe, as demonstrated in the present case. Modification of entry and surgicalapproaches and preoperative planning are important when considering surgery during pregnancy. Reliefof pain symptoms during pregnancy will lead to a positive pregnancy experience.

7407 A Self-Made Bag Assisted LESS in Ovarian Teratomectomy during Pregnancy

<h3>Study Objective</h3> To show how ovarian teratoma during Pregnancy can be safely managed with laparoendoscopic single-site surgery. <h3>Design</h3> Stepwise demonstration of the technique with narrated video footage. <h3>Setting</h3> The reported incidence of ovarian cysts in pregnancy varies from 0.05% to 1.2%, Compared with open surgery, laparoscopic surgery adnexal cyst during pregnancy does not increase the risk of mother and fetus. LESS has better postoperative recovery. However, conventional laparoscopic surgery is safer than LESS. <h3>Patients or Participants</h3> The patient was a 31-year-old woman, gravida 3, para 2, at gestational age of 15 weeks who was diagnosed with 5.6*4.1cm right ovarian teratoma and 2.0*2.3cm left ovarian cyst. Teratomectomy was performed at the same time of the previous cesarean section in 2018. <h3>Interventions</h3> A Self-made Bag Assisted LESS approach to ovarian teratoma with several key strategies to minimize fetal impact, ovarian damage, blood loss: 1. Make a retrieval bag before surgery with inner packaging bag of the disposable suction tube. 2. Place the affected ovary in the retrieval bag and pull the bottom of the retrieval bag to the umbilicus. To reduce the stimulation of the uterus by surgical procedures. 3. Cut the surface of the affected ovary with a cold blade to reduce ovarian damage. 4.Cut the teratoma pedicle with an ultrasonic knife to reduce bleeding. <h3>Measurements and Main Results</h3> N/A. <h3>Conclusion</h3> When performing an ovarian cystectomy under LESS, we could use upside-down specimen bag to remove the cyst from abdominal cavity conveniently, quickly and with no pollution. Self-made specimen bag is cost-saving, convenient to use. The operation has the least impact on the pregnant uterus and avoids the impact on the fetus. And cold knife and suture are used in the operation to maximize the protection of ovarian function.

OP07.03: Decidualised ovarian cysts in pregnancy: ultrasound features and management

OP07.03: Decidualised ovarian cysts in pregnancy: ultrasound features and management

A case of successful pregnancy outcome with a large ovarian cyst- a case report.

Background: Ovarian cyst in pregnancy though uncommon but may be associated with adverse maternal and fetal outcome. Case Presentation: A 30 year old multi gravida, presented during pregnancy at 34 weeks with antenatal ultrasonographic diagnosis of huge unilateral ovarian cyst and normal obstetrics findings. Elective lower segment caesarean section (LSCS) with left salpingo-oophorectomy was done at 37 weeks of gestation. Conclusion: Though a rare event but Ovarian cyst in pregnancy must be followed up carefully. Early diagnosis, timely and appropriate intervention is the key to the best of maternal and fetal outcome. With proper planning, management and expertise the pregnant women with ovarian cyst can have a good maternal and fetal outcome.

Ovarian cysts in Pregnancy: Obstetric Outcome and Management

Objective: To study the pregnancy outcome and management of ovarian cysts during pregnancy. Methods : A prospective observational study was conducted in Prathima Institute of Medical Sciences, Karimnagar from June 2018 to June 2020. A total of 32 cases with ovarian cysts 5cm with benign features as suggested by ultrasound were included in the study. The pregnancy outcome and management were studied. Results : Out of 32 pregnant women with ovarian cysts, 25(78.12%) were asymptomatic and were managed conservatively. Of the 25, spontaneous resolution was seen in 18(56.25%) patients while 7(21.87%) patients in whom ovarian cyst persisted or was incidentally detected during cesarean section were managed by cystectomy at the same time. Surgery was needed in the antenatal period in 7(21.87%) patients due to complications such as increase in size of the cyst seen in 4(12.5%) and torsion seen in 3(9.37%). All the 32 patients had good perinatal outcome. There were no miscarriages. All patients continued to term except one, who presented at 36 weeks with torsion, andunderwent emergency cesarean section with oophorectomy. Histopathological examination of the excised cysts showed 5 as simple cyst, 5 as serous cystadenomas, 3 as mucinous cystadenomas and 1 as dermoid. Conclusion: Management of the ovarian cysts during pregnancy is conservative. Most of them undergo spontaneous resolution. Surgical management is reserved for only symptomatic patients. Pregnancy outcome as such is not affected by ovarian cysts during pregnancy.

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

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.

Torsion of an Ovarian Cyst in Pregnancy

Torsion of the ovary is the partial or total rotation of the ovary over its pedicle. It is unusual for it to occur in the second trimester. We report a case of a 35year old G10P9+0A7 at 17weeks gestation who presented with acute severe abdominal pain. She was found to have an ovarian cyst in pregnancy. She had Exploratory Laparotomy where a huge gangrenous cyst was found and Salpingoophorectomy was performed. The pregnancy continued without any problems. The histology report showed a Simple Cyst.

LARGE SOLITARY LUTEINIZED FOLLICULAR CYST OF PREGNANCY AND PUERPERIUM IN RUPTURED ECTOPIC PREGNANCY MANAGED LAPAROSCOPICALLY

Abstract&#x0D; Background: Ovarian cysts in pregnancy are encountered in approximately 1 in 100 cases. Of these, most are benign. One such non-neoplastic lesion is Large Solitary Luteinized Follicular Cyst of Pregnancy and Puerperium (LSLFCPP). They are a rare lesion with unknown pathogenesis. They grow rapidly to very large sizes, causing symptoms. They are hormonally inactive. Maternal and fetal outcome is usually unaffected.&#x0D; Objective: we present a case of a Large Solitary Luteinized Follicular Cyst of Pregnancy and Puerperium encountered incidentally during the management of ruptured ectopic pregnancy. A 25 year old G2A1 with 7 weeks 3 days gestational age by dates presented to the emergency department with the chief complaints of sudden onset of pain in the lower abdomen accompanied by nausea and giddiness since 12 hours. What sets our case apart from rest in literature is it’s diagnosis very early in pregnancy. Also, it is, to our knowledge, the only case reported in literature, in an ectopic pregnancy.&#x0D; Conclusion: LSLFCPPis a rare, yet important entity to be kept in mind when evaluating patients with large ovarian cysts in pregnancy. Comprehensive management is the need of the hour, in order to ensure ideal maternal and fetal wellbeing.

Recurrent Ovarian Cyst in Pregnancy, The Advantage of Laparoscopic Approach – A Case Report

Recurrent Ovarian Cyst in Pregnancy, The Advantage of Laparoscopic Approach – A Case Report

Giant Ovarian Mucinous Cystadenoma Complicating Term Pregnancy

Huge ovarian cyst are found in less than 1% of all ovarian cyst in pregnancy and are associated with poor feto-maternal outcome. A 28 years old G2P1 with history of normal vaginal delivery 3 years back was referred from local health post with complains of intermittent pain abdomen at 29 weeks. Her scan showed huge ovarian cyst of 18.9×17.6 cm with multiple thick septation. Woman was conservatively managed till term and elective surgery was planned however she presented in labour with breech presentation at 39 weeks and 4days. Emergency lower segment caesarian section along with left sided salpingo-oophorectomy was done along with delivery of 2.5 kg healthy female baby. Histopathology was suggestive of mucinous cystadenoma of ovary. Although antepartum removal of ovarian cyst has been recommended to ensure good pregnancy outcome, expectant management and timed intervention can be adopted for pregnancy with huge ovarian cysts. Keywords: mucinous cystadenoma; ovarian cyst; pregnancy.

Laparoscopic Surgery for Large Ovarian Cysts-Review

Introduction: Laparoscopic surgery has been increasingly applied to different gynecologic problems with excellent surgical outcome and rapid recovery. Large ovarian cysts, a relatively common gynecologic problem, pose certain challenges to laparoscopic management. Objective: The aim of the present study was to review published reports on laparoscopic surgery for large ovarian cysts and summarize their findings regarding patients’ selection, surgical outcome, technical methods and the final pathology report. Methods: A review of the English language literature of the MEDLINE (PubMed) database was performed using the key words: ovarian cysts, laparoscopy, large, huge and robotic. An additional collection of reports was found by systematically reviewing all references from retrieved papers. The review was limited to case reports including 5 or more patients and excluded laparoscopic surgery for ovarian cysts in pregnancy. Results: A total of 20 studies including 852 patients were identified. There was one prospective randomized study. The operative and postoperative complication rates were 1.9% and 3.9% of the cases were converted to laparotomy. Borderline ovarian tumors and ovarian cancers were identified in 2.5% and 3.1% of the patients, respectively. The incidence of borderline tumors and ovarian cancer varied depending on the selection criteria used for management of women with large ovarian cysts laparoscopically. Criteria for patients’ selection and surgical techniques employed to reduce tumor spill and extract the large cysts are reviewed. Conclusions: Laparoscopy is a safe technique for managing patients with large ovarian cysts and is associated with low conversion and complication rates. The chance of finding unexpected ovarian cancer varies according to the patients’ selection criteria but is low overall.

Laparoscopic Aspiration of an Ovarian Cyst in Pregnancy

Laparoscopic Aspiration of an Ovarian Cyst in Pregnancy

Laparoscopic Management of Ovarian Cysts in Pregnancy: Study of Surgical Outcome and Obstetric Outcome.

Laparoscopic Management of Ovarian Cysts in Pregnancy: Study of Surgical Outcome and Obstetric Outcome.

Giant Ovarian cyst in Term Pregnancy - A rare case report

Ovarian cyst in pregnancy may have a poor feto-maternal outcome. A 25 year old multi gravida, post caesarean pregnancy at term reported with antenatal ultrasonography (USG) diagnosis of giant unilocular ovarian cyst and normal obstetrics findings. Elective lower segment caesarean section (LSCS) with left salpingo-oophorectomy and right partial salpingectomy was done. Left ovarian cyst was 29x20 cm in size with smooth surface, no adhesion, no free fluid in peritoneal cavity and a normal right ovary. Histopathological examination revealed mucinous cystadenoma of ovary. Post-operative period was uneventful. The rarity of the case and its successful management prompted us for reporting along with review of literatures.

Maternal And Neonatal Outcome In Pregnancy With Large Gynaecology Tumour

Gynaecological tumour in pregnancy is a complex problem that requires the expertise of multidisciplinary task force. The tumour mass may be asymptomatic and unintentionally found or may be undetected until it reached a voluminous size and occupied the abdominal cavity. Most of gynaecological tumours in pregnancy are diagnosed unintentionally during visits or during first trimester ultrasound screening. Although the data are conflicting and most women with a large sized ovarian cyst in pregnancy may be complicated by torsion, rupture, haemorrhage, infection, as well as obstruction in delivery. And women with a large sized fibroids have uneventful pregnancies, the weight of evidence in the literature suggests that uterine fibroids are associated with an increased rate of spontaneous miscarriage, preterm labor, placenta abruption, malpresentation, labor dystocia, cesarean delivery, and postpartum hemorrhage. Individual treatment is the main issue when gynaecological tumour is diagnosed during pregnancy. When faced with the problem of gynaecological tumour in pregnancy, a thorough evaluation and avoidance of emergency procedure hazardous to both mother and the baby is needed. The treatment of a gynaecological tumour during pregnancy should be based on stage of pregnancy, the nature of the tumour, individual symptoms, safety of the foetus, and considering the fertility of the patient after treatment. Treatment should be given to maximize the survival rate and at the most proper time point.

Ovarian Cancer in Early Pregnancy, an Unusual Presentation

The incidence of diagnosed ovarian carcinoma in pregnancy is rare, reported as 0.018-0.073/1000 pregnancies [1]. Very few cases are reported in the English literature regarding management of ruptured malignant ovarian cyst in pregnancy; almost all the cases reported described patients in the third trimester of pregnancy.

Symptomatic Ovarian Cyst In Pregnancy -Laparoscopic Assisted Ovarian Cystectomy —An Alternative, Qualitative, Feasible, Safe Option.

Study objects: To assess the feasibility and safety of laparoscopic approach for symptomatic ovarian cyst in pregnancy. Design: This is a retrospective analysis of symptomatic ovarian cysts in pregnancy of four pregnant women managed by Laparoscopic Assisted Cystectomy. Setting: Melaka General Hospital, Melaka, Malaysia A Teaching tertiary hospital for under and postgraduate students . Patients: Four ante-natal patients with symptomatic ovarian cysts of different sizes ranging from 12 weeks to 26 weeks in 1st and 2nd trimester of pregnancy from August 2005 to May 2007. Intervention: Laparoscopic Assisted Cystectomy in pregnancy.Measurements and Main results: Out of 4 four cases, two in first trimester of pregnancy about 9-11/52 (nine to eleven weeks) size presented with acute abdomen. Others were in about 14 to 18 weeks with recurrent pressure symptoms contributing to continuous lower abdominal pain and urinary obstruction. The size of cysts varied from 12weeks to 26 weeks of pregnancy with clinical diagnosis of serious cyst adenoma in 2 cases and dermoid cyst in another two cases. All patients were duly counseled about the probable anesthesia risk and also the benefits and risks of the open versus laparoscopic approach. Under general anesthesia all case were successfully operated maintaining 10 mm Hg intra abdominal pressure without any Trendlenburg position. Mean blood loss was less than 50 cc with average operating time less than 50 minutes. Mean hospital stay was about 36 hours. There was no miscarriage or preterm labour. All except one(caesarean section) had spontaneous uneventful vaginal delivery with normal apgar score without any gross abnormality. On follow-up, both mothers and babies are well. Histopathology reported benign serous cystadenoma in two cases and mature dermoid cysts in other cases. No evidence of malignancy seen. On follow up all babies had normal growth chart. Conclusion: Laparoscopic Assisted Ovarian Cystectomy in pregnancy in selected cases is a feasible, safe,qualitative and an alternative option.

Symptomatic Ovarian Cyst In Pregnancy -Laparoscopic Assisted Ovarian Cystectomy —An Alternative, Qualitative, Feasible, Safe Option.

Study objects: To assess the feasibility and safety of laparoscopic approach for symptomatic ovarian cyst in pregnancy. Design: This is a retrospective analysis of symptomatic ovarian cysts in pregnancy of four pregnant women managed by Laparoscopic Assisted Cystectomy. Setting: Melaka General Hospital, Melaka, Malaysia A Teaching tertiary hospital for under and postgraduate students . Patients: Four ante-natal patients with symptomatic ovarian cysts of different sizes ranging from 12 weeks to 26 weeks in 1st and 2nd trimester of pregnancy from August 2005 to May 2007. Intervention: Laparoscopic Assisted Cystectomy in pregnancy.Measurements and Main results: Out of 4 four cases, two in first trimester of pregnancy about 9-11/52 (nine to eleven weeks) size presented with acute abdomen. Others were in about 14 to 18 weeks with recurrent pressure symptoms contributing to continuous lower abdominal pain and urinary obstruction. The size of cysts varied from 12weeks to 26 weeks of pregnancy with clinical diagnosis of serious cyst adenoma in 2 cases and dermoid cyst in another two cases. All patients were duly counseled about the probable anesthesia risk and also the benefits and risks of the open versus laparoscopic approach. Under general anesthesia all case were successfully operated maintaining 10 mm Hg intra abdominal pressure without any Trendlenburg position. Mean blood loss was less than 50 cc with average operating time less than 50 minutes. Mean hospital stay was about 36 hours. There was no miscarriage or preterm labour. All except one(caesarean section) had spontaneous uneventful vaginal delivery with normal apgar score without any gross abnormality. On follow-up, both mothers and babies are well. Histopathology reported benign serous cystadenoma in two cases and mature dermoid cysts in other cases. No evidence of malignancy seen. On follow up all babies had normal growth chart. Conclusion: Laparoscopic Assisted Ovarian Cystectomy in pregnancy in selected cases is a feasible, safe,qualitative and an alternative option.

Ovarian cyst impacted in the pouch of Douglas at 20 weeks' gestation managed by laparoscopic ovarian cystectomy: a case report

IntroductionThe frequency of ovarian cysts in pregnancy is reported to be 1 in 1000 pregnancies. Laparoscopic ovarian cystectomy has been described in the literature as case series but this is the first case where an ovarian cyst at 20 weeks' gestation impacted in the pouch of Douglas was managed exclusively by laparoscopy.Case presentationA 31-year-old primigravida woman was diagnosed as having an 11 cm ovarian cyst at 20 weeks' gestation. At the 19th week routine ultrasound scan, the mass appeared to be cystic with no solid component. She was asymptomatic. In view of the size of the cyst, options were discussed with her including laparoscopic ovarian cystectomy which she agreed to. Laparoscopic surgery during pregnancy is reported to be safe and beneficial for pregnant women. At laparoscopy, a transvaginal scan was performed to localize the cyst and an ovarian cystectomy was carried out. The patient had an uneventful recovery and subsequent antenatal period. She had a lower segment caesarean section for non-progress of labour when both ovaries were found to be normal and mobile.ConclusionsLaparoscopic surgery during pregnancy has numerous advantages compared to open laparotomy. This is a rare example of an ovarian cyst in the pouch of Douglas impacted behind the uterus which was managed by laparoscopy and shows the safety of the technique in the presence of an expert laparoscopic surgeon.

Operative laparoscopy; is it a safe option in pregnancy?

We report a case of an ovarian cyst in pregnancy complicated by torsion of the cyst requiring urgent surgical intervention at 13 weeks of gestation. The case was successfully managed by laparoscopic ovarian cystectomy without any maternal or fetal complications. Thus proving that operative laparoscopy in pregnancy is a safe and feasible option. Approximately 0.2% of pregnant women require intra-abdominal general surgery during pregnancy. Benefits of laparoscopic surgery compared to the traditional open surgery are well recognised; notably, a shorter hospital stay and a reduced rate of post-operative complications. Pregnancy poses unique surgical and anaesthetic problems due to altered physiology and anatomy in pregnancy. The effect of the pneumoperitoneum on the maternal haemodynamic status, risk of uterine/fetal damage by trocar entry, risk of miscarriage and preterm labour are some serious concerns that may limit the feasibility and safety of operative laparoscopy in pregnancy. In the past few decades, there has been increasing evidence emerging in the medical literature supporting the safety of operative laparoscopy in pregnancy. The second trimester is considered to be the safest period in terms of least risk to the fetus and also seems more favourable for the technical aspect of the laparoscopic procedures. Hasson’s method of laparoscopic entry technique is prudent to avoid possible uterine injury. Although absolute safety of laparoscopic surgery during pregnancy in humans is yet to be established, presently, operative laparoscopy by an experienced laparoscopist is considered a safe and effective alternative to traditional laparotomy. Prospective randomised controlled studies in this clinical territory are lacking.