07 Apr Ovarian Cyst Pregnancy
Ovaries are 2 small oval shaped organs in the lower part of the abdomen. They produce eggs and female hormones. The egg is developed in a sac (cyst) filled with nourishing fluid. Every month, the cyst bursts and the egg is released by a process called ovulation. Sometimes the development for egg release is not completed, and the cyst continues to grow. This is known as functional cyst and is usually less than 5 cm. It will remain in the ovary for a while and then gradually disappear. Occasionally, the ovaries produce cyst which is not connected to egg production. This will persist and may continue to expand.
In the first trimester, it is fairly common to have functional cyst. This will subside with time and seldom gives rise to complication.
Persistent ovarian cyst is not common in pregnancy, occurring in about 1 in 1,000 to 2000 pregnant women. Majority are non-cancerous. Ultrasound scan may be helpful in determining if the cyst is benign or cancerous although it cannot be 100 percent accurate. If the scan shows that the cyst is small, and is filled with clear fluid, without any thick walls or solid materials, it is probably not cancerous.
The problem with large cyst (e.g. more than 5 cm) during pregnancy is that it may rupture or twist on itself. Its wall may bleed and the cyst contents may get infected. This causes very severe pain in the abdomen and requires immediate surgical removal. This may lead to miscarriage or premature delivery for the baby.
If large ovarian cyst is discovered in the first trimester and does not subside spontaneously over the course of a few weeks, it should be removed. In pregnancy, the best time to operate is in the second trimester, around 14-16 weeks. The cyst may be dealt with by laparoscopy (key-hole surgery), or by laparotomy through a large, open incision.