Invasive fetal therapies: approach and results in treating fetal ovarian cysts.
ABSTRACT To show the validity of prenatal invasive surgical intervention when a fetal ovarian cyst is diagnosed, compared to a wait and see attitude, in order to avoid possible prenatal and postnatal complications.
Fourteen cases of intra-abdominal cysts monitored in our center between April 2005 and November 2010. All cases were first diagnosed in the third trimester, and were monitored for the remainder of the pregnancy and after delivery (2 months-3 years postnatally). SURGICAL INTERVENTION: Upon maternal and fetal cutaneous anesthesia performed trans-amniotically, the cystic fluid (mean contents 43.85 cc, DS 46.27) was extracted for cytological, biochemical, and hormonal examination.
Thirteen cases of intra-abdominal cysts (92.8%) were fetal ovarian cysts. Ninety-two percent of pregnancies bearing such a condition were successfully concluded (n = 12). Sixty-nine percent concluded in vaginal delivery (n = 9). None experienced maternal and/or fetal complications. Every drained cyst had an estradiol concentration higher than 10,000 pg/ml.
The aspiration of ovarian cysts exceeding a 40 mm diameter, performed as early as possible, allows a good longitudinal treatment of this fetal affection, thus avoiding torsion, tissue necrosis, and invasive postnatal surgery, as well as giving hope of future gestational capability to the fetus/newborn.
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ABSTRACT: Three cases of ovarian cysts diagnosed antenatally by sonography are analyzed. Two patients also had congenital hypothyroidism, and one of these also had hypertrophic pyloric stenosis. The significance of fetal ovarian cysts is discussed, with emphasis on the implications for clinical management of the baby. In instances where screening thyroid function tests are not routinely performed on all newborns, prenatal identification of ovarian cysts should be considered as an indication to evaluate thyroid status.Radiology 04/1984; 150(3):809-12. · 6.34 Impact Factor