ANTENATAL ULTRASONOGRAPHIC DIAGNOSIS AND MANAGEMENT OF FETAL OVARIAN CYSTS

OBJECTIVES: The aim of the present study was to evaluate the outcome o f fetal ovarian cysts in relation to their ultrasonic appearance and s ize. METHODS. Forty-two fetal ovarian cysts were diagnosed in 41 fetus es and followed with serial ultrasonograms in utero and after birth un til spontaneous or surgical resolution. RESULTS: Twelve fetal ovarian cysts that were echogenic at diagnosis and six that were anechoic at d iagnosis but became echogenic at subsequent prenatal sonograms were al l submitted to postnatal surgery. Of the remaining 24 cysts, all anech oic, four were successfully aspirated in utero, 11 resolved spontaneou sly after birth, and nine underwent postnatal surgery for complication . The outcome of cysts that were anechoic at diagnosis was significant ly correlated with size (P = 0.O1). CONCLUSIONS: Echogenic fetal ovari an cysts should be always surgically removed. The outcome of anechoic cysts depends on the size at diagnosis, and serial ultrasonographic as sessment is recommended; although not randomized, the present series s uggests that in utero aspiration of cysts >5 cm may prevent complicati on and subsequent oophorectomy.