Objectives Abdominal cysts are frequently detected in fetuses through routine prenatal ultrasound.
In female fetuses such cysts are most often originated from ovaries under the stimulus of maternal hormones, and can grow to a rather large size.
We present our survey of prenatally detected ovarian cysts (OC) and we propose a management and follow-up protocol.
Methods A retrospective review of all cases of abdominal cysts in female fetuses detected in our institution from jan. 2007 to jan. 2012 was conducted.
Among all cases of abdominal cystic formations, 28 were originated from the ovary, and resulted at antenatal US scan ranging in diameter from 15 to 90 mm. 17 cases showed spontaneous regression up to a complete remission, 13 of them measuring < 50 mm, while all other cases were managed surgically with a laparoscopic approach. When ovarian parenchyma was macroscopically evident it has been preserved. In 4 cases pathologic examination showed absence of any trace of ovarian parenchyma.
Results 11 cysts, all showing associated fluid corpuscular content were treated surgically, 8 of them larger than 50mm and. Among these, 5 presented torsion and one auto-amputation. In one case anaphylactic shock occurred during surgery. In all cases in which ovarian parenchyma was preserved, US follow-up at three months after surgery showed vital ovarian tissue.
Conclusions Ovarian cysts with size exceeding 50 mm are related to high risk of torsion. Cysts with corpuscular content show almost no tendency to regression after depletion of maternal hormones stimulation: surgery appears to be indicated after proper clinical observation.