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Ultraschall Med 2003; 24(1): 21-26
DOI: 10.1055/s-2003-37414
Originalarbeit
© Georg Thieme Verlag Stuttgart · New York

Fetal Ovarian Cysts: Development and Neonatal Outcome

Fetale Ovarialzysten: Pränatale Diagnostik und Neonatales OutcomeC.  Mittermayer1 , W.  Blaicher1 , D.  Grassauer1 , E.  Horcher2 , J.  Deutinger1 , G.  Bernaschek1 , B.  Ulm1
  • 1Department of Obstetrics and Gynaecology, Division of Prenatal Diagnosis and Therapy
  • 2Department of Surgery, Division of Paediatric Surgery, University Hospital of Vienna, Austria
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Publication History

eingereicht: 13. Mai 2002

angenommen: 14. November 2002

Publication Date:
24 February 2003 (online)

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Abstract

Introduction: The aim of the study was to evaluate the outcome of fetal ovarian cysts in relation to their size and ultrasonic appearance. Methods: We retrospectively analysed pre- and postnatal charts of 61 infants with a prenatal diagnosis of ovarian cysts between 1991 and 2000. Results: In a total of 61 fetuses 65 ovarian cysts were detected by transabdominal ultrasound: 35 (57 %) cysts on the left side, 22 (36 %) on the right side and 4 fetuses (7 %) had bilateral cysts. Three patients with uncomplicated cysts were lost to follow-up and one fetus with bilateral cysts died in the 27th week of gestation. In 17 cysts treatment was necessary. 14 cysts (all complicated) were operated after delivery because of persistence or enlargement. The histological results were either follicular or theca lutein cysts in 12 cases, one lymphangioma and one teratoma. Two cysts were aspirated in utero and one after delivery. In the remaining 40 fetuses, 43 cysts where only controlled by ultrasound. 8 cysts regressed before delivery and 35 cysts after delivery independent of their sonographic appearance. The mean diameter of cysts that required treatment was significantly different from the mean diameter of cysts that resolved spontaneously (6.8 [SD 2.4] cm vs. 3.3 [SD 0.8] cm; p < 0.01). Conclusion: Complicated cysts which do not regress should be treated either by laparotomy or laparoscopically after delivery. Uncomplicated cysts which exceed 5 cm could be treated by in utero aspiration or aspiration after delivery to avoid further complications. Cysts smaller than 5 cm, presenting the tendency to regress, should be left untouched independent of their sonographic appearance.

Zusammenfassung

Einleitung: Das Ziel der Studie war es, das Outcome pränatal diagnostizierter, fetaler Ovarialzysten im Verhältnis zu ihrer Größe und sonomorphologischen Charakteristik zu erheben. Methodik: Retrospektive Analyse der prä- und postnatalen Krankengeschichten von 61 Kindern im Zeitraum von 1991-2000, bei denen pränatal eine fetale Ovarialzyste diagnostiziert wurde. Ergebnisse: Bei 61 Feten wurden insgesamt 65 Zysten mittels transabdominellem Ultraschall festgestellt. 35 (57 %) Zysten am linken, 22 (36 %) am rechten Ovar und 4 Feten hatten bilaterale Ovarialzysten. Ein Kind mit bilateralen Zysten verstarb in utero in der 27. SSW, 3 weitere erschienen nicht mehr zu den vorgeschriebenen Kontrollen. Bei 17 Zysten war eine Therapie notwendig. 14 komplizierte Zysten wurden nach der Geburt operativ entfernt. In 10 Fällen wurde eine Torsion festgestellt, bei 2 Zysten eine Einblutung. In zwei Fällen ergab die histologische Aufarbeitung ein Lymphangiom bzw. ein Teratom. Zwei unkomplizierte Zysten wurden während der Schwangerschaft punktiert und eine Zyste nach der Geburt. In den restlichen 40 Feten wurden 43 Zysten mittels Ultraschall kontrolliert. 8 Zysten verschwanden pränatal, die restlichen 35 postnatal, unabhängig von ihrer sonomorphologischen Charakteristik. Der mittlere Durchmesser jener Zysten, bei denen eine therapeutische Intervention notwendig wurde, war signifikant größer als der mittlere Durchmesser der Zysten die sich spontan zurückbildeten (6,8 [SD 2,4] cm ver. 3,3 [SD 0,8] cm; p < 0.01). Schlussfolgerung: Komplizierte Zysten, die sich nicht spontan zurückbilden, sollten chirurgisch entfernt werden. Unkomplizierte Zysten größer als 5 cm sollten in utero oder nach der Geburt punktiert werden, um weitere Komplikationen zu vermeiden. Zysten kleiner als 5 cm, welche die Tendenz zeigen sich spontan zurückzubilden, sollten nur sonographisch kontrolliert werden, unabhängig von ihrer sonographischen Charakteristik.

Key words

Prenatal diagnosis - ultrasound - ovarian cysts - management

Schlüsselwörter

Pränatale Diagnostik - Ultraschall - Ovarialzysten - Management

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C. Mittermayer

University Hospital of Vienna · Department of Obstetrics and Gynaecology · Division of Prenatal Diagnosis and Therapy

Währinger Gürtel 18-20 · 1090 Vienna · Austria ·

Phone: ++43/1/40400/2996

Fax: ++43/1/40400/2995

Email: christoph-mittermayer@gyn.akh.magwien.gv.at

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