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Original Article

Invasive fetal therapies: approach and results in treating fetal ovarian cysts

, , , , , , , , & show all
Pages 299-303 | Received 01 Mar 2011, Accepted 17 Mar 2011, Published online: 19 May 2011
 

Abstract

Objective. To show the validity of prenatal invasive surgical intervention when a fetal ovarian cyst is diagnosed, compared to a wait and see attitude, in order to avoid possible prenatal and postnatal complications.

Patients. Fourteen cases of intra-abdominal cysts monitored in our center between April 2005 and November 2010. All cases were first diagnosed in the third trimester, and were monitored for the remainder of the pregnancy and after delivery (2 months–3 years postnatally).

Surgical intervention. Upon maternal and fetal cutaneous anesthesia performed trans-amniotically, the cystic fluid (mean contents 43.85 cc, DS 46.27) was extracted for cytological, biochemical, and hormonal examination.

Results. Thirteen cases of intra-abdominal cysts (92.8%) were fetal ovarian cysts. Ninety-two percent of pregnancies bearing such a condition were successfully concluded (n = 12). Sixty-nine percent concluded in vaginal delivery (n = 9). None experienced maternal and/or fetal complications. Every drained cyst had an estradiol concentration higher than 10,000 pg/ml.

Conclusions. The aspiration of ovarian cysts exceeding a 40 mm diameter, performed as early as possible, allows a good longitudinal treatment of this fetal affection, thus avoiding torsion, tissue necrosis, and invasive postnatal surgery, as well as giving hope of future gestational capability to the fetus/newborn.

Declaration of interest: The manuscript has been read and approved by all the authors. All authors think that it is an honest work. The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the paper.

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