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Newborn and Infant Care

Baby Cyst in Ovary 4cm

07/12/2010

Question:

My sister in law is pregnant for 37 weeks already. She just went to doctor last Friday for common check up and was told that her baby (girl) has a cyst in her ovary 4cm big. Because she lives in a small town in Indonesia and doesn`t have many knowledge about this disease, I would like to help her as much as possible. I live in Japan now.

I search baby cyst ovary in internet and found this website.

Please advise how to treat and take necessary action for an unborn baby girl with 4cm cyst in ovary so she can survive and live healthy. Just for information, my sister had delivered 3 kids without any problem. This is the 4th pregancy and first time for her to have this experience.

Thank you.

Answer:

According to an article by Politylo, and others published in 2008, about 38% of female fetuses show ovarian cysts on ultrasound. Most of them (63% or more) are complex cysts not simple cysts. Simple cysts can safely be followed by repeated ultrasound examination and many will go away without any treatment at all.

Ovarian cysts are more worrisome if they are larger than 2 cm as is the case for your sister-in-law's baby. These larger cysts need to be examined laporascopically after birth. Laparascopic surgery reduces the risk for blood loss and scarring in the abdomen that could further impair later fertility.

Cysts are usually decapsulated (the wall of the cyst is removed) to preserve any normal ovarian tissue and allow for examination of the removed tissue to see if it is normal (benign) or malignant (cancerous).

Removing the cyst's capsule also allows drainage of any blood or fluid present, making the cyst smaller, and eliminating the chance for torsion or twisting of the cyst later on. Torsion of the cyst would be extremely painful to the baby and risk an infection inside the baby's abdomen that could make her very ill or even lead to her death.

Babies who have the surgery will need an abdominal ultrasound follow-up every 6 months at least throughout the early years to see if there is a growth in ovarian tissue (0-25% likelihood) or evidence of a new cyst or other problem. Ovarian tissue grows back very slowly, so it would be years before anything definite was known about possible functioning ovarian tissue. However, one ovary that functions well preserves the ability to have children.

The other option is to remove all of the ovary and the fallopian tube on the affected side. This means that there is a complete loss of any fertile ovarian function on that side. Again the tissue would be examined to determine if there is a cancer present that requires more treatment.

I am sure all of this information is very concerning but there is effective treatment available and many baby girls do well. I hope the baby does well!

Politylo, P., Zaparackaite, I., Khan, K., & Mahomed, A. Ovarian reconstitution following laparoscopic decapsulation of congenital cyst. Journal of Laparoendoscopic & Advanced Surgical Techniques, 18, 895-897.

Luzzato, C., Midrio, P.,  Toffolutti, T., & Suma, T. (2000). Neonatal ovarian cysts: Management and follow-up. Pediatric Surgery international, 16, 56-59.

Goya, E., Carmina, D., Nuria, T., et al. (2005). Conservative versus surgical treatment for complex neonatal ovarian cysts: Outcomes study. AJR, 185, 501-508.

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Response by:

Mary M Gottesman, PhD, RN, CPNP, FAAN Mary M Gottesman, PhD, RN, CPNP, FAAN
Professor of Clinical Nursing
College of Nursing
The Ohio State University