Fetal ovarian cysts: a report of three cases managed by intrauterine aspiration

Small follicular or functional theca-lutein cysts are a common finding in f etal and neonatal ovaries. After delivery decrease of hormonal stimulation may lead to spontaneous resolution of the cyst. A high rate of complication has been underlined by recent studies, the most common being ovarian torsi on with subsequent loss of the ovary. Because torsion may happen with any s ize of cyst, however large or small, we suggest in utero decompression even in small fetal ovarian cysts (< 5 cm). We report here three cases of such cysts managed by intrauterine aspiration with good outcome and no further n eed for neonatal surgery. In all cases cytology of the cyst aspirate demons trated numbers of granulosa cells and fluid biochemistry showed a high amou nt of estradiol, progesterone, and testosterone that confirmed the etiology as ovarian. Despite the small size of the cysts, no technical difficulties were encountered and no maternal or fetal morbidity occured. Prenatal mana gement of fetal ovarian cysts remains controversial, however, and our limit ed experience needs to be assessed on a larger number of cases.