Antenatal Surgical Management for Ovarian Cysts: 13 Years’ Experience

Abstract

Objective: To evaluate the outcome of surgically treated ovarian cysts during the antenatal period in 51 women.
Methods: The outcome of pregnant women who underwent surgery during the antenatal period for ovarian cyst from January 2003 to December 2015 at a university hospital in Hong Kong was retrospectively reviewed. Operative details, histopathology of the ovarian cyst, pregnancy complications, and neonatal outcome were assessed.
Results: Of 51 women surgically treated for ovarian cyst during pregnancy, 29 were operated electively in the late first or early second trimester (mean [range] gestational age, 14 [8-22] weeks) and 22 were emergency operations (mean [range] gestational age, 13 [4-32] weeks). There were no intra-operative complications or adverse neonatal
outcome. The most common pathology was mature cystic teratoma (22/54, 40.7%). Most ovarian cyst complications occurred between 7 and 13 weeks of gestation (72.7%) and when the size of the cyst was >6 cm (81.8%).
Conclusion: Elective surgery for ovarian cyst in the late first or second trimester can be achieved safely with a laparoscopic approach. Ovarian cysts >6 cm are at risk of complications and warrant elective surgery. Accurate diagnosis of ovarian cyst complications during pregnancy can be made clinically based on symptoms and ultrasonographic findings.