Ovarian cyst in pregnancy

An ovarian cyst during pregnancy can be asymptomatic, but in some cases it can complicate the normal course of pregnancy, which is why constant monitoring by a doctor of the cyst development process is so necessary.

Ovarian cysts in women can form at any stage of life, including during pregnancy. According to statistics, this happens to one pregnant woman out of a thousand.

Causes of ovarian cysts during pregnancy

The reasons that can lead to the formation of a cystic formation during pregnancy are not fully understood at the moment. A number of factors contributing to the development of a cyst have been identified:

• hormonal disorders, disorders of the secretory glands;
• congenital predisposition of the organism;
• nutritional disorders that provoke hormonal imbalance;
• stressful situations, disturbance of psycho-emotional balance;
• long-term use of contraceptives;
• menstrual cycle disorders, early puberty;
• obesity or underweight;
• frequent abortions;
• lack of sexual intercourse;
• early cessation of lactation;
• inflammatory diseases of the reproductive organs;
• infectious processes in the body;
• unhealthy lifestyle.

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Symptoms of ovarian cysts during pregnancy

The uncomplicated form of cystic formation is often asymptomatic and is discovered accidentally during ultrasound examination of the pelvic organs. The presence of symptoms largely depends on the size and location of the cyst, as well as its nature.

Endometrioid ovarian cyst during pregnancy

The signs of an endometrioid cyst are not specific: these include menstrual irregularities, lower abdominal pain (especially before menstruation and in the first days of menstruation), prolonged failure to conceive, and bowel dysfunction (constipation alternating with diarrhea). Often, you can notice the appearance of smearing "chocolate discharge". If the cyst is relatively small, there may be no symptoms. Cyst growth is unpredictable: it may be slow, or very rapid, or absent for a long time. The main symptoms of such a cyst appear when complications develop - cyst rupture followed by peritonitis. This condition requires immediate surgical intervention.

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Follicular ovarian cyst during pregnancy

In many women, signs of a follicular cyst include a feeling of pressure and heaviness in the projection area of the affected ovary. As the cyst grows, pain may be detected, which intensifies when bending, running quickly, or during sexual intercourse. These signs usually worsen in the second half of the cycle, after the 14th day of menstruation. An additional indirect symptom of this type of cyst may be a decrease in basal temperature in the postovulatory period. Often, it barely reaches 36.8 C. A follicular cyst is prone to regression and may disappear on its own within 2 months.

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Parovarian cyst of the ovary during pregnancy

A cystic formation of not very large size is discovered by chance. Complaints begin when the size of the formation reaches 15 cm or more. The abdomen increases, the organs experience pressure, reproductive function disorder, dysfunctional uterine bleeding may be observed. Periodic pain in the abdomen, sacral area is noted. When the growing cyst begins to squeeze nearby organs, women may note digestive function disorders, bladder, discomfort and pain during sexual intercourse.

Functional ovarian cyst during pregnancy

Functional cysts include follicular formations and corpus luteum cysts. The size of such cysts can reach 80 mm. Small functional cysts tend to disappear on their own, without posing a danger to the body. Large formations can twist: this condition is considered critical and is accompanied by severe sharp pain in the area of the cyst. Signs of torsion are sometimes mistaken for an acute attack of appendicitis.

Dermoid cyst of the ovary during pregnancy

The initial stages of a dermoid cyst usually have no clinical symptoms. Signs appear when the cyst grows to 15 cm or more. Temperature may rise, weakness and abdominal pain may appear. A dermoid cyst usually does not contribute to hormonal imbalances and does not cause menstrual cycle disorders.

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Ovarian retention cyst during pregnancy

A retention cyst does not have any specific characteristic signs. Women usually come with complaints of various types of pain in the lower abdomen or menstrual dysfunction. A clear manifestation of the disease is observed only in complications: this is a torsion of the cyst or hemorrhage into its cavity.

A cyst of the right ovary during pregnancy may be similar in symptoms to an attack of acute appendicitis, inflammation of the lower ileum, and the ascending colon. Therefore, in this situation, consultation with both a gynecologist and a surgeon is extremely important. A cyst of the left ovary during pregnancy may be virtually asymptomatic, and if there is pain, it may resemble the symptoms of damage to the transverse colon and sigmoid colon.

The localization of pain may not always correspond to the location of the affected organ, so the patient's examination should be as comprehensive as possible.

Consequences of ovarian cysts during pregnancy

If you managed to get pregnant despite the presence of a cyst, that's great. However, the cyst must be constantly monitored, periodically undergoing ultrasound and visiting a gynecologist. The cyst can become dangerous when it begins to increase in size: it disrupts the natural position of the appendages, can put pressure on the uterus, creating the preconditions for spontaneous termination of pregnancy or premature onset of labor.

The pressing action of the cyst can provoke its necrosis, cyst inversion. All this contributes to the development of the inflammatory process, which leads to the need for emergency surgical intervention, even against the background of an existing pregnancy.

In rare cases, rapid development and malignancy of the neoplasm is observed.

The risk of complications during childbirth increases especially: intense contractions and excessive tension of the muscles of the anterior abdominal wall can lead to a rupture of the cystic formation. In such cases, there is a need for immediate surgery, since this situation threatens the life of the expectant mother.

If the cyst is small, its growth is inactive, and it does not cause discomfort to the woman, then it is simply observed without taking any measures. After childbirth, the issue of further treatment is decided.

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Rupture of ovarian cyst during pregnancy

Rapid growth of pathological cysts can pose a certain danger to the body. This can contribute to twisting of the pedicle of the formation, increased pressure inside the cyst and its rupture. Clinical signs begin with the appearance of acute pain in the lower abdomen, which is expressed mainly on the affected side. The pain is accompanied by nausea, and often vomiting. The temperature jumps sharply, the pulse accelerates. Leukocytosis and increased ESR are detected in the blood.

During vaginal examination, pain may be most intense on the side and back of the uterus.

The following symptoms are considered signs of a cyst rupture:

• the appearance of sudden sharp pain in the lower abdomen;
• a sharp jump in temperature that cannot be eliminated with conventional medications;
• sudden weakness;
• vaginal discharge, including bloody discharge;
• attacks of nausea;
• drop in blood pressure, dizziness, even loss of consciousness.

The cyst breaks through into the abdominal cavity, which provokes the development of peritonitis, a serious inflammatory process. This situation requires immediate hospitalization with surgical intervention, since peritonitis without assistance can cause death.

If you have a cyst, visit your gynecologist regularly and monitor its development to prevent complications. If the tumor does not progress and its size is stable, it is simply monitored. If desired, the cyst can be removed after the birth of the child. If complications develop, in severe situations, surgical intervention can be performed even during pregnancy: in the overwhelming majority of cases, specialists manage to save the lives of both the mother and the baby.

Diagnosis of ovarian cysts during pregnancy

It is quite difficult to detect a cystic formation solely by symptoms, since most cysts are asymptomatic. An exception may be the development of complications, when signs of an inflammatory process become obvious.

Many people wonder if it is possible to determine the presence of a cyst using a pregnancy test? Of course not. An ovarian cyst and a pregnancy test are not related in any way. If you have a cyst, and the pregnancy test is positive, insist on taking a blood test for human chorionic gonadotropin (beta-hCG). There are three reasons for this situation: either the tests are of poor quality and "lie", or you are really pregnant despite the cyst, or the doctors did not notice the development of an ectopic pregnancy behind the cyst. The sooner you take the hCG test, the sooner measures will be taken to preserve your health, especially if it concerns an ectopic pregnancy.

There are also quite a few cases where doctors have confused an ovarian cyst with pregnancy. From a medical point of view, such a development of events was possible only in the last century. There is the same hCG analysis, which is carried out dynamically, several times during the month. A cyst does not increase hCG levels, much less progress! If you do not trust your doctor, change the specialist. The approach to diagnostics and treatment of patients should be individual, and one ultrasound is not always enough to make a diagnosis.

The main methods for diagnosing cysts are:

• Ultrasound using transvaginal angle;
• computer tomography of appendages;
• diagnostic laparoscopy.

These are the most informative methods for determining a cyst. Additionally, the doctor may prescribe a blood test for tumor markers, hormones, a general blood and urine test, bacterial cultures, and a puncture biopsy.

The diagnostic method of laparoscopy can be combined with the simultaneous removal of the cystic formation, which minimizes tissue damage and improves the prognosis of the disease.

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Treatment of ovarian cysts during pregnancy

Functional cystic lesions, such as corpus luteum cysts and follicular cysts, do not require surgical intervention in the vast majority of cases. Cysts are monitored by monitoring their growth using ultrasound. Most functional cysts regress on their own over time.

Surgical intervention is performed on those cysts that are pathological or do not resolve on their own within three monthly cycles. In addition, complicated cysts that reach large volumes, compress surrounding tissues and organs, and, of course, twisted and ruptured formations are subject to mandatory surgical treatment.

Some doctors are inclined to believe that the risk of developing a functional cyst can be reduced by using contraceptive pills. There is a grain of truth in this, because such drugs suppress ovulation. The most commonly prescribed drugs are Janine and Regulon. The tablets are taken once a day every day at the same time, the course of treatment is usually 21 days. However, the duration of treatment is determined individually by the doctor and, if necessary, an additional course can be prescribed. The use of such treatment during pregnancy is certainly contraindicated.

Removal of an ovarian cyst during pregnancy is usually performed only in cases of extreme necessity. Usually, the birth of the child is expected and only after that, if necessary, the cyst is removed. As a rule, removal is performed by laparoscopy, less often - laparotomy. During laparotomy, the anterior leaf of the uterine ligament is dissected and the cyst is carefully enucleated, limiting itself to healthy tissues. In this case, the appendages are not damaged, and the tube is restored after the operation.

The risk of spontaneous termination of pregnancy in the postoperative period is small. After surgery, pregnancy preservation therapy is mandatory.

Laparoscopy of ovarian cyst during pregnancy

Laparoscopic surgery is usually performed in the first half of pregnancy, if possible before 12-16 weeks.

The surgical intervention is performed under intravenous anesthesia. The surgeon makes 3 punctures: in the umbilical region and in the projection areas of the appendages.

With the help of a laparoscope, the doctor can monitor the operation and examine the condition of the reproductive organs for other hidden pathologies. The operation for laparoscopic cyst removal can last from 30 minutes to 2 hours, depending on the circumstances. Before the operation, the woman must undergo a blood test, an ECG and fluorography, and consult an anesthesiologist. It is better not to eat solid food the day before the operation, and not to eat or drink at all for 10 hours. A cleansing enema may be administered the day before and on the day of the operation.

The woman is usually discharged on the second or third day after laparoscopy, if there are no complications. Later, as a rule, the pregnant woman is placed on bed rest to prevent possible consequences of the operation.

Possible contraindications to laparoscopic surgery may include:

• too much body weight;
• asthmatic condition;
• infectious diseases;
• hypertension;
• cardiac disorders, anemia.

The only drawback of laparoscopy is that this operation can remove a cyst of not very large size, up to 6 cm in diameter. Cysts of significant volume are removed using surgical laparotomy.

Prevention of ovarian cysts during pregnancy

When preparing for conception, a woman should undergo a full examination, including an ultrasound examination to check for the presence of neoplasms. Therefore, elements such as cysts should be removed before pregnancy.

If a woman becomes pregnant without knowing about the cyst, she should undergo regular examination and monitor its growth. If the cyst does not bother her, there is no need to touch it.

The prognosis of an ovarian cyst during pregnancy does not differ from that before the period of gestation. A cyst at any stage of life can behave unpredictably, but constant monitoring of its development, assessment of the growth of the cyst in dynamics provides a greater chance of carrying a child without problems, and only after the birth of the baby to begin treatment.

An ovarian cyst during pregnancy is not a reason to have an abortion: modern medicine and your responsible attitude to the problem will allow you to bear and give birth to a healthy child.

Ovarian cyst and pregnancy planning

Each monthly cycle of a woman is accompanied by the growth of follicles in the ovaries. After reaching a certain size, ovulation occurs - the follicle bursts. If ovulation does not occur for one reason or another, the unruptured follicle becomes a follicular cyst. It is believed that as long as there is a cyst in one of the ovaries (follicular or corpus luteum), further growth of follicles is impossible, therefore, ovulation will not occur. Such cysts will pass on their own within 2 months, after which ovulation will resume and conception will become possible.

Other types of cystic formations (endometrioid, dermoid) do not directly affect the development of follicles and the ability to ovulate. However, depending on the size and location of the cyst, this formation can create a mechanical obstacle to the normal process of conception, put pressure on the follicles, and affect the hormonal background. This situation is extremely individual: in one patient, the cyst does not interfere with conception, while in another it creates a problem. Therefore, after several unsuccessful attempts at conception, if there are no other potential causes of infertility, specialists recommend removing pathological cysts, especially since such formations do not tend to regress on their own.