Ultrasound features of prenatally diagnosed ovarian cysts: what is important for the prognosis
DOI: 10.32364/2618-8430-2022-5-4-287-291
I.V. Tihonenko
Belarusian Medical Academy of Postgraduate Education, Minsk, Republic of Belarus
Aim: to assess the outcomes of prenatally diagnosed ovarian cysts and to identify ultrasound features associated with the prognosis of surgical treatment.
Patients and Methods: this retrospective study evaluated 59 fetal ovarian cysts diagnosed during ultrasound screening in the prenatal ultrasound center. The following parameters were reviewed: parity, maternal age, time of prenatal diagnosis, ultrasound cystic features and structure, and the outcomes of fetal ovarian cysts.
Results: fetal ovarian cysts were detected during pregnancy in women with a median age of 30.6 years (17–42 years), 40.7% of them were primipara. A median gestational age at the date of prenatal cyst diagnosis was 33.5 (21.2–38) weeks of pregnancy. In 25.4% of cases the ovarian cysts had complex echotexture, and in 33.2% of cases a cyst diameter was ≥40 mm. In 32.2% of cases, the cysts were located at some distance from the bladder; 39% of the cysts were fully or partially visualized in the abdomen. The spontaneous cyst resolution by the time of delivery was reported in 37.3% of cases, including 40% of complex cysts. After birth, 35.6% of ovarian cysts disappeared and 20% of complex cysts demonstrated regression. Also, the regression occurred in 26.3% of cysts ≥ 40 mm. Overall, spontaneous resolution was reported for 60% of complex cysts, 42.1% of cysts ≥40 mm, 52.6% of cysts distinct from the bladder and 56.5% of cysts loca ted in the abdomen. Postnatal surgery was performed in 27.1% of the newborn girls. The likelihood of surgical treatment was higher in the newborns with prenatal cysts ≥ 40 mm comparing to cysts < 40 mm (odds ratio (OR), 7.78 (95% confidence interval (CI), 2.12–28.53)) and cysts located in the abdomen comparing to cysts located in the fetal pelvis (OR, 16.25 (95% CI, 3.84–68.82)). No correlation was found between ultrasound features of ovarian cysts and torsion.
Conclusion: the ultrasound features of prenatally diagnosed ovarian cysts which are important for predicting a higher risk of postnatal surgical procedures include the cyst diameter (≥ 40 mm) and the location (especially in the abdomen). These factors should be taken into consideration for choosing a maternity hospital and prenatal consulting of parents.
Keywords: fetal ovarian cyst, prenatal diagnosis, ultrasound features, outcome, prognosis.
For citation: Tihonenko I.V. Ultrasound features of prenatally diagnosed ovarian cysts: what is important for the prognosis. Russian Journal of Woman and Child Health. 2022;5(4):287–291 (in Russ.). DOI: 10.32364/2618-8430-2022-5-4-287-291.
About the author:
Irina V. Tihonenko — C. Sc. (Med.), associate professor, Dean of the Faculty of Public Health and Healthcare, Belarusian Medical Academy of Postgraduate Education; 3/3, Petrusya Brovki str. Minsk, 220072, Republic of Belarus; ORCID iD 0000-0001-7948-3508.
Contact information: Irina V. Tihonenko, e-mail: tihonenko2019@rambler.ru.
Financial Disclosure: the author has no financial or property interest in any material or method mentioned.
There is no conflict of interests.
Received 05.10.2022.
Revised 28.10.2022.
Accepted 23.11.2022.
2. Иваницкая О.Н., Одегова Н.О., Андреева Е.Н. Кисты яичников у плодов. Особенности пренатальной диагностики и постнатальный исход. Российский вестник акушера-гинеколога. 2020;20(1):73–80. DOI: 10.17116/rosakush20202001173. [Ivanitskaya O.N., Odegova N.O., Andreeva E.N. Ovarian cysts in fetuses — features of prenatal diagnosis and postnatal outcome. Russian Bulletin of Obstetrician-Gynecologist. 2020;20(1):73–80 (in Russ.)]. DOI: 10.17116/rosakush20202001173.
3. Fetal Abdominal Cysts. American Pediatric Surgical Association. Prenatal Counseling. Series Congenital. 2018:8.
4. Trinh T.W., Kennedy A.M. Fetal ovarian cysts: review of imaging spectrum, differential diagnosis, management, and outcome. Radiographics. 2015;35(2):621–635. DOI: 10.1148/rg.352140073.
5. Nussbaum A.R., Sanders R.C., Hartman D.S. et al. Neonatal ovarian cysts: sonographic-pathologic correlation. Radiology. 1988;168(3):817–821. DOI: 10.1148/radiology.168.3.3043551.
6. Nguyen K.T., Reid R.L., Sauerbrei E. Antenatal sonographic detection of a fetal theca lutein cyst: a clue to maternal diabetes mellitus. J Ultrasound Med. 1986;5(11):665–667. DOI: 10.7863/jum.1986.5.11.665.
7. Jafri S.Z., Bree R.L., Silver T.M., Ouimette M. Fetal ovarian cysts: sonographic detection and association with hypothyroidism. Radiology. 1984;150(3):809–812. DOI: 10.1148/radiology.150.3.6695083.
8. Bascietto F., Liberati M., Marrone L. et al. Outcome of fetal ovarian cysts diagnosed on prenatal ultrasound examination: systematic review and meta-analysis. Ultrasound Obstet Gynecol. 2017;50(1):20–31. DOI: 10.1002/uog.16002.
9. Hara T., Mimura K., Endo M. et al. Diagnosis, Management, and Therapy of Fetal Ovarian Cysts Detected by Prenatal Ultrasonography: A Report of 36 Cases and Literature Review. Diagnostics (Basel). 2021;11(12):2224. DOI: 10.3390/diagnostics11122224.
10. Society for Maternal-Fetal Medicine (SMFM), Cheng Y. Ovarian cysts. Am J Obstet Gynecol. 2021;225(5):B23–B25. DOI: 10.1016/j.ajog.2021.06.042.
11. Perez R., Pomares A., Bravo C. et al. Congenital Ovarian Cyst: Diagnosis and Perinatal Management. J Gynecol Neonatal Biol. 2015;1(1):1–5.
12. Thanawala N., Akuma A.O. Symptomatic congenital ovarian cyst in a monochorionic twin. Arch Dis Child Fetal Neonatal Ed. 2011;96:Fa24.
13. Tyraskis A., Bakalis S., Scala C. et al. A retrospective multicenter study of the natural history of fetal ovarian cysts. J Pediatr Surg. 2018;53(10):2019–2022. DOI: 10.1016/j.jpedsurg.2018.02.049.
14. Rotar I.C., Tudorache S., Staicu A. et al. Fetal Ovarian Cysts: Prenatal Diagnosis Using Ultrasound and MRI, Management and Postnatal Outcome-Our Centers Experience. Diagnostics (Basel). 2021;12(1):89. DOI: 10.3390/diagnostics12010089.
15. Тихоненко И.В., Бучель Ю.Ю. Опыт ультразвуковой и МРТ-диагностики 49 случаев кист яичников плода. Пренатальная диагностика. 2019;4:346–350. [Tikhonenko I.V., Buchel’ Yu.Yu. Experience of ultrasound and MRI-diagnostics in 49 fetal ovarian cysts. Prenatal diagnosis. 2019;4:346–350 (in Russ.)].
16. Diguisto C., Winer N., Benoist G. et al. In-utero aspiration vs expectant management of anechoic fetal ovarian cysts: open randomized controlled trial. Ultrasound Obstet Gynecol. 2018;52(2):159–164. DOI: 10.1002/uog.18973.
17. Manjiri S., Padmalatha S.K., Shetty J. Management of Complex Ovarian Cysts in Newborns — Our Experience. J Neonatal Surg. 2017;6(1):3. DOI: 10.21699/jns.v6i1.448.
18. Husen M., Schut P.C., Neven A.C.H. et al. Differences in Origin and Outcome of Intra-Abdominal Cysts in Male and Female Fetuses. Fetal Diagn Ther. 2019;46(3):166–174. DOI: 10.1159/000495506.
19. Nakamura M., Ishii K., Murata M. et al. Postnatal outcome in cases of prenatally diagnosed fetal ovarian cysts under conservative prenatal management. Fetal Diagn Ther. 2015;37(2):129–134. DOI: 10.1159/000365146.
20. Yilanlioğlu N.C., Semiz A., Akpak Y.K. et al. Fetal Ovarian Cyst Torsion: Antenatal Evaluation and Management. Bezmialem Science. 2016;2:80–82. DOI: 10.14235/bs.2016.764.
21. Caprio M.G., Di Serafino M., De Feo A. et al. Ultrasonographic and multimodal imaging of pediatric genital female diseases. J Ultrasound. 2019;22(3):273–289. DOI: 10.1007/s40477-019-00358-5.
22. Коровин С.А., Дзядчик А.В., Галкина Я.А., Соколов Ю.Ю. Лапароскопические вмешательства у девочек с перекрутами придатков матки. Российский вестник детской хирургии, анестезиологии и реаниматологии. 2016;6(2):73–79. [Korovin S.A., Dzyadchik A.V., Galkina Ya. A., Sokolov Yu.Yu. Laparoscopic treatment in girls with adnexal torsion. Russian Journal of Pediatric Surgery, Anesthesia and Intensive Care. 2016;6(2):73–79 (in Russ.)].
This work is licensed under a Creative Commons «Attribution» 4.0 License.
