A Retrospective Multicenter Study of the Natural History of Fetal Ovarian Cysts

TY - JOUR

T1 - A Retrospective Multicenter Study of the Natural History of Fetal Ovarian Cysts

AU - Tyraskis, Athanasios

AU - Bakalis, Spyros

AU - Scala, Carolina

AU - Syngelaki, Argyro

AU - Giuliani, Stefano

AU - Davenport, Mark

AU - David, Anna L.

AU - Nicolaides, Kypros

AU - Eaton, Simon

AU - De Coppi, Paolo

PY - 2018/2/12

Y1 - 2018/2/12

N2 - Aim We investigated the natural history of fetal ovarian cysts to estimate the risk of torsion according to size. Methods Cases were identified from 1/1/2000 until 1/1/2015. Data were collected pre- and postnatally on cyst size and sonographic features until an outcome of surgery, torsion, or resolution. Fisher's exact test categorical data and logistic regression for the significance of size on torsion; P value < 0.05 was considered significant. Results 37 patients with unilateral ovarian cysts were included. 12 (32%) resolved spontaneously prenatally, 14 (38%) resolved spontaneously postnatally, 5 (14%) underwent surgery postnatally and 6 (16%) cases underwent torsion. Rate of torsion increased with size from 0% (n = 0) in cysts ≤ 20 mm to 33% (n = 2) in cysts > 50 mm, however, the overall trend failed to reach statistical significance (P = 0.1). Cysts of 0-40 mm had a significantly higher rate of spontaneous resolution (90% vs. 44% in > 40 mm, P = 0.003), but the rate of torsion was not significantly different (10% in 0-40 mm vs. 25% in > 40 mm, P = 0.26). The median time to postnatal resolution was 10 (5–27) weeks in those treated conservatively. Conclusion Cysts > 40 mm are significantly less likely to resolve spontaneously, however torsion showed no significant correlation with cyst size. No complications were observed in cysts < 20 mm. Level of Evidence. IV, case series with no comparison group.

AB - Aim We investigated the natural history of fetal ovarian cysts to estimate the risk of torsion according to size. Methods Cases were identified from 1/1/2000 until 1/1/2015. Data were collected pre- and postnatally on cyst size and sonographic features until an outcome of surgery, torsion, or resolution. Fisher's exact test categorical data and logistic regression for the significance of size on torsion; P value < 0.05 was considered significant. Results 37 patients with unilateral ovarian cysts were included. 12 (32%) resolved spontaneously prenatally, 14 (38%) resolved spontaneously postnatally, 5 (14%) underwent surgery postnatally and 6 (16%) cases underwent torsion. Rate of torsion increased with size from 0% (n = 0) in cysts ≤ 20 mm to 33% (n = 2) in cysts > 50 mm, however, the overall trend failed to reach statistical significance (P = 0.1). Cysts of 0-40 mm had a significantly higher rate of spontaneous resolution (90% vs. 44% in > 40 mm, P = 0.003), but the rate of torsion was not significantly different (10% in 0-40 mm vs. 25% in > 40 mm, P = 0.26). The median time to postnatal resolution was 10 (5–27) weeks in those treated conservatively. Conclusion Cysts > 40 mm are significantly less likely to resolve spontaneously, however torsion showed no significant correlation with cyst size. No complications were observed in cysts < 20 mm. Level of Evidence. IV, case series with no comparison group.

KW - Fetal ovarian cyst

KW - ovarian torsion

KW - prenatal diagnosis

KW - ultrasound

KW - prenatal aspiration

KW - fetal intervention

U2 - 10.1016/j.jpedsurg.2018.02.049

DO - 10.1016/j.jpedsurg.2018.02.049

M3 - Article

SN - 0022-3468

JO - Journal of Pediatric Surgery

JF - Journal of Pediatric Surgery

ER -