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Management of Complex Ovarian Cysts in Newborns - Our Experience
S Manjiri1, S K Padmalatha1, J Shetty1
1Department of Pediatric Surgery, M.S. Ramaiah Medical College, Bangaluru-560054, India.
Insights
Antenatal ovarian cysts in newborns often resolve spontaneously. Complex or large cysts require surgical intervention, preferably laparoscopy, with preservation of ovarian tissue when possible.
Area of Science:
- Pediatric Surgery
- Gynecologic Oncology
- Neonatal Care
Background:
- Ovarian cysts are common in female fetuses, detected via antenatal ultrasound.
- Management strategies vary, necessitating a clear understanding of clinical presentation and outcomes.
Purpose of the Study:
- To analyze the clinical presentation, clinicopathological correlation, and management of complex ovarian cysts in newborns and infants.
- To evaluate the outcomes of different treatment modalities for neonatal ovarian cysts.
Main Methods:
- A retrospective study of 25 newborns diagnosed with ovarian cysts antenatally.
- Data collection included clinical features, radiological findings, pathology, and treatment methods over a 6-year period.
- Follow-up data on spontaneous regression and surgical outcomes were analyzed.
Main Results:
- Fourteen (56%) of the 25 diagnosed ovarian cysts showed spontaneous regression by 6-8 months.
- Eight neonates and 3 infants underwent surgical intervention (laparoscopy or laparotomy).
- Histopathology revealed diverse cyst types; post-operative recovery was uneventful in all operated cases.
Conclusions:
- Close postnatal follow-up is crucial for all antenatally detected ovarian cysts in female fetuses.
- Surgical intervention should be reserved for complex or large cysts, with laparoscopy being the preferred method.
- Ovarian preservation is possible for simple cysts, while complex cysts may necessitate oophorectomy due to atrophic ovarian tissue.
Aims:
To analyse the clinical presentation, clinicopathological correlation and management of complex ovarian cysts in newborn and infants.
Materials And Methods:
Over a period of 6 years (2009-2015), 25 newborns who were diagnosed to have ovarian cyst on antenatal ultrasound, were followed up. We collected data in the form of clinical features, radiological findings, pathology and mode of treatment.
Results:
Of the 25 fetuses who were diagnosed to have ovarian cysts, fourteen (56%) underwent spontaneous regression by 6-8 months. Eight were operated in newborn period while 3 were operated in early infancy. Seven had ovarian cyst on right side, 4 had on left side. Eight babies underwent laparoscopy while 3 underwent laparotomy. Histopathology showed varied features of hemorrhagic cyst with necrosis and calcification, serous cystadenoma with hemorrhage, benign serous cyst with hemorrhage and simple serous cyst. Post-operative recovery was uneventful in all.
Conclusion:
All the ovarian cysts detected antenatally in female fetuses need close follow-up after birth. Since spontaneous regression is known, only complex or larger cysts need surgical intervention, preferably by laparoscopy. Majority of the complex cysts show atrophic ovarian tissue hence end up in oophorectomy but simple cysts can be removed preserving normal ovarian tissue whenever possible.
