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
,
4   Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Duke University Health System, Durham, North Carolina
› Institutsangaben

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.

Financial Support

None.




Publikationsverlauf

Eingereicht: 06. November 2022

Angenommen: 10. September 2023

Accepted Manuscript online:
29. September 2023

Artikel online veröffentlicht:
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/)

Thieme Medical Publishers, Inc.
333 Seventh Avenue, 18th Floor, New York, NY 10001, USA

 
  • References

  • 1 Montes de Oca MK, Dotters-Katz SK, Kuller JA, Previs RA. Adnexal masses in pregnancy. Obstet Gynecol Surv 2021; 76 (07) 437-450
  • 2 Whitecar MP, Turner S, Higby MK. Adnexal masses in pregnancy: a review of 130 cases undergoing surgical management. Am J Obstet Gynecol 1999; 181 (01) 19-24
  • 3 Khaw KT, Walker WJ. Ultrasound guided fine needle aspiration of ovarian cysts: diagnosis and treatment in pregnant and non-pregnant women. Clin Radiol 1990; 41 (02) 105-108
  • 4 Lee DJ, Heggen DM, VanderKolk HL. Transvaginal aspiration of an ovarian tumor with a benign ultrasound appearance during the second trimester of pregnancy. J Clin Ultrasound 1992; 20 (02) 135-138
  • 5 Bannon LC, Hayes KG, Porter KB. Percutaneous drainage of a rapidly enlarging simple ovarian cyst in the third trimester. Mil Med 2015; 180 (10) e1118-e1120
  • 6 Duke D, Colville J, Keeling A, Broe D, Fotheringham T, Lee MJ. Transvaginal aspiration of ovarian cysts: long-term follow-up. Cardiovasc Intervent Radiol 2006; 29 (03) 401-405
  • 7 American College of Obstetricians and Gynecologists' Committee on Practice Bulletins—Gynecology. Practice Bulletin No. 174: evaluation and management of adnexal masses. Obstet Gynecol 2016; 128 (05) e210-e226