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CC BY-NC-ND 4.0 · AJP Rep 2023; 13(04): e82-e84
DOI: 10.1055/a-2184-0548
Case Report

Transvaginal Ovarian Cyst Drainage in Third Trimester to Facilitate Vaginal Delivery

Vivienne T. Meljen
1   Department of Obstetrics and Gynecology, Duke University Health System, Durham, North Carolina
2   Department of Obstetrics and Gynecology, Washington State University Elson S. Floyd School of Medicine, Spokane, Washington
,
Carmen M. Avram
1   Department of Obstetrics and Gynecology, Duke University Health System, Durham, North Carolina
,
Nicole P. Kerner
3   Division of Women and Community Population Health, Department of Obstetrics and Gynecology, Duke University Health System, Durham, North Carolina
,
Eleanor H. J. Rhee
4   Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Duke University Health System, Durham, North Carolina
,
Jeffrey A. Kuller
4   Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Duke University Health System, Durham, North Carolina
,
Sarahn M. Wheeler 
4   Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Duke University Health System, Durham, North Carolina
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Abstract

Adnexal masses in the third trimester of pregnancy may obstruct the pelvic outlet precluding labor induction and vaginal delivery. Expectant versus surgical management of adnexal cysts in pregnancy must carefully weigh maternal–fetal benefits and risks. Simple benign appearing cysts with low likelihood of malignancy may be amenable to percutaneous drainage as a bridge to interval postpartum laparoscopic cystectomy. We demonstrated posterior culdocentesis as a safe, minimally invasive technique to decompress a simple benign appearing left adnexal cyst obstructing the pelvic outlet in the third trimester at the time of labor induction to facilitate vaginal delivery and prevent primary cesarean delivery. Detailed sonographic cyst evaluation and counseling on underlying risk of malignancy must be considered to guide shared decision-making.

Keywords

adnexal - culdocentesis - cyst - ovarian - pregnancy - transvaginal

Financial Support

None.




Publication History

Received: 06 November 2022

Accepted: 10 September 2023

Accepted Manuscript online:
29 September 2023

Article published online:
28 November 2023

© 2023. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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