Pregnancy is a transformative and joyous time in a woman’s life, but it can also bring about various health concerns. One such concern is the development of ovarian cysts during pregnancy. As a Gynaecologist based in London with expertise in treating both benign and malignant gynaecological conditions, including ovarian cysts, I understand the importance of addressing these issues with precision and care.
What are Ovarian Cysts?
Ovarian cysts are fluid-filled sacs that form on or within the ovaries. While most ovarian cysts are benign and pose no threat to pregnancy, their presence can still raise concerns and require close monitoring. These cysts can vary in size, and their development is often linked to the hormonal changes that accompany the menstrual cycle.
Ovarian Cysts in Pregnancy:
The occurrence of ovarian cysts during pregnancy is not uncommon. In fact, many women may already have cysts present before becoming pregnant. However, the hormonal fluctuations and changes in the pelvic anatomy during pregnancy can influence the behaviour of these cysts.
One particular concern is the potential for cysts to rupture or twist (ovarian torsion), leading to complications that may impact both the mother and the developing foetus. Therefore, it is crucial to understand the management options available for pregnant individuals with ovarian cysts.
Management of Ovarian Cysts in Pregnancy:
1. Close Monitoring:
- Regular ultrasounds are essential for monitoring the size and characteristics of ovarian cysts during pregnancy.
- Serial ultrasounds can help track changes and identify any potential issues that may arise.
https://pubmed.ncbi.nlm.nih.gov/34849310/
In this systematic review the authors led by Asst Prof Sayasneh found that Ultrasound appears to have an adequate accuracy in differentiating benign from malignant masses in pregnancy. However, more research is required to assess the role of ultrasound models, rules, and subjective assessment in pregnancy compared to non-pregnant women.
2. Medical Management:
- In some cases, hormonal medications may be prescribed to regulate and control the size of the cyst.
- This approach aims to prevent cyst enlargement and minimise the risk of complications.
3. Surgical Intervention:
- Surgical intervention may be necessary if the cyst becomes large, causes persistent pain, or poses a threat to the health of the mother and the foetus.
- Minimally invasive surgical techniques, such as laparoscopy, are often preferred to reduce the impact on the pregnancy.
https://www.bjmp.org/content/ovarian-masses-pregnancy-single-centre-retrospective-study
A previous study I led show that invasive cancer in pregnancy is rare. The results show a significant relation between the size of adnexal mass and the probability of surgery.
4. Risk Assessment:
- A thorough risk assessment, considering factors such as the type and size of the cyst, the stage of pregnancy, and the overall health of the patient, guides decision-making regarding the optimal management strategy.
Conclusion
In conclusion, managing ovarian cysts during pregnancy requires a multidisciplinary approach, involving close collaboration between obstetricians and gynaecological specialists. As a Gynaecologist in London, my commitment to providing comprehensive care extends to addressing the unique challenges that ovarian cysts present during pregnancy.
By staying vigilant through regular monitoring, utilising medical management when appropriate, and considering surgical intervention when necessary, we can ensure the well-being of both the mother and the developing foetus. As I continue to contribute to the field, I remain dedicated to advancing our understanding of gynaecological conditions and providing the highest standard of care to my patients.
