CONGENITAL OVARIAN CYST: DIAGNOSIS AND PERINATAL MANAGEMENT

Objective: To describe prenatal and postnatal outcomes of ultrasonographically diag-nosed fetal ovarian cysts (FOC) and to review the literature to propose an obstetric management algorithm. Methods: We performed a retrospective analysis of fetuses with an ultrasound-based diagnosis of FOC. The size, location, and ultrasound features of the cysts were recorded. Follow-up and treatment modalities are described. Results: 13 of 16 had follow-up data. Almost all cases were diagnosed in the third trimester. FOC was mostly unilateral, with a mean diameter of 40.4 mm. The cysts were classified as simple in 12 cases (75%). Eleven cases (68.7%) remained stable, and 2 resolved spontaneously (12.5%) during pregnancy. No associated anomalies or chromosomal abnormalities were found. Postnatal management was surgical in 50% of cases, with laparoscopy as the main procedure. Cystectomy and salpingo-oophorec-tomy were performed in 4 infants each. Conclusions: FOC is frequently isolated. Prognosis is generally good. Regular ultra-sound is necessary before and after birth to detect complications that could endanger the ovarian parenchyma. Conservative management is recommended in simple cysts under 4 cm, and surgical procedures can be performed in larger simple cysts or when complications are suspected. Tissue-sparing surgery is preferable.