[Ovarian cysts and pregnancy]

Area of Science:

• Reproductive Medicine
• Gynecologic Oncology
• Obstetrics

Background:

• Ovarian cysts are common in early pregnancy, often functional and asymptomatic.
• The incidence of ovarian cysts after 16 weeks of gestation ranges from 0.5% to 3.0%.
• Histologically, these cysts resemble those in non-pregnant women, primarily dermoid and functional types.

Purpose of the Study:

• To review the frequency, histology, risk of complications, management, and obstetrical consequences of ovarian cysts during pregnancy.
• To provide guidance on the appropriate management of adnexal masses detected during gestation.

Main Methods:

• Literature review of studies on ovarian cysts in pregnancy.
• Analysis of cyst characteristics (size, type, ultrasound findings) and their association with complications.
• Evaluation of surgical and non-surgical management options based on gestational age.

Main Results:

• Most small, unilocular cysts (<5 cm) and dermoid cysts (<6 cm) without malignant criteria are benign and regressive.
• Ovarian cancer is rare, occurring in 1 in 15,000 to 32,000 pregnancies.
• Laparoscopy is preferred until 16-17 weeks; laparotomy is recommended after 17 weeks for surgical interventions.
• Cesarean delivery may require cyst removal if the cyst obstructs labor.

Conclusions:

• Conservative management (observation) is appropriate for most asymptomatic ovarian cysts during pregnancy.
• Surgical intervention should be considered for cysts with suspicious ultrasonographic findings or those causing complications.
• Management strategies must be tailored to cyst characteristics and gestational age to ensure maternal and fetal well-being.