COMPLICATED FETAL OVARIAN CYSTS AND THEIR ULTRASOUND DIAGNOSIS

Objective. To establish echographic signs characteristic of different types of complicated fetal ovarian cysts and to choose the most rational management tactics for pregnant women and neonatal infants, by taking into account the found abnormality. Material and methods. Sixteen cases of ultrasound diagnosis of complicated fetal ovarian cysts revealed at 33—38 weeks gestation were examined. There was in utero torsion of an ovarian cyst in 10 cases, ovarian apoplexy in 1, a ruptured or hemorrhagic ovarian cyst in 1 and 4 cases, respectively. When fetal space-occupying lesion was found, its site and size were estimated and its internal structure was determined. Dynamic fetal ultrasound monitoring was also done to assess mass dimensional and structural changes throughout the remaining period of gestation and after birth. Results. The echographic signs of this abnormality were described. Emergency delivery at 33 weeks gestation was required in 1 case of ovarian apoplexy and intraabdominal hemorrhage; full-term births occurred in the other 15 cases. Post-birth surgery was performed in 11 (in utero torsion of an ovarian cyst) and 5 (rupture or hemorrhage of a cyst) cases — the abnormal mass spontaneously disappeared. Neonatal survival was 100%. Conclusion. Echography is a valuable technique the use of which makes it possible to establish an in utero diagnosis of a complex abnormality, such as complicatedfetal ovarian cysts, and, relying on the findings, to decide which of the most rational pregnancy management tactics and treatment options for the newborn should be chosen.

echography, ovarian cyst, ovarian apoplexy, cyst wall rupture, hemorrhagic cyst, fetus, prenatal diagnosis, fetal malformations