Ultrasound features of prenatally diagnosed ovarian cysts: what is important for the prognosis

Abstract

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.