Ovarian cyst during pregnancy

Ovarian cyst during pregnancy can be asymptomatic, but in some cases it can complicate the normal course of pregnancy, so the constant monitoring of the doctor for the development of cysts is so necessary.

Ovarian cysts in women can be formed in any life period, including during pregnancy. According to statistics, this occurs in one pregnant woman out of a thousand.

Causes of ovarian cysts during pregnancy

The reasons that can lead to the formation of cystic education in pregnancy, at the moment are not fully understood. A number of factors contributing to the development of cysts are identified:

• hormonal disorders, disorders of the secretory glands;
• congenital predisposition of the organism;
• disturbances in the diet that provoke hormonal imbalance;
• stressful situations, violation of psychoemotional balance;
• long reception of contraceptives;
• disorders of the monthly cycle, early puberty;
• obesity or lack of weight;
• frequent abortions;
• absence of sexual contacts;
• early cessation of lactation;
• inflammatory diseases of the reproductive organs;
• infectious processes in the body;
• Unhealthy Lifestyle.

[1], [2]

Symptoms of ovarian cysts during pregnancy

Uncomplicated form of cystic education occurs more often asymptomatically and is detected accidentally with ultrasound of the pelvic organs. The presence of symptoms largely depends on the size and location of the cyst, as well as on its nature.

Endometrioid ovarian cyst during pregnancy

The signs of the endometrioid cyst are not specific: they are malfunctions of menstrual function, tenderness of the lower abdomen (especially before menstruation and in the early days of menstruation), long failure of conception, intestinal disorders (constipation, followed by diarrhea). Often you can see the appearance of smearing "chocolate secretions." If the cyst is relatively small, the symptomatology may not manifest itself. The growth of the cyst is unpredictable: it can be slow, or very stormy, or not at all for a long time. The main symptomatology of such a cyst manifests itself in the development of a complication - a rupture of the cyst followed by peritonitis. This condition requires immediate surgery.

[3], [4], [5], [6], [7]

Follicular ovarian cyst during pregnancy

In many women, the signs of the follicular cyst become sensations of pressure and severity in the projection zone of the affected ovary. With an increase in the volume of the cysts, pain can be detected, which is enhanced by tilting, rapid running, and sexual intercourse. Usually, these symptoms are exacerbated 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 post-ovulatory period. Often it barely reaches 36.8 C. The follicular cyst is prone to regression and can disappear on its own within 2 months.

[8]

Paraovarial ovarian cyst during pregnancy

Cystic formation of not very large sizes is detected by chance. Complaints begin when the size of the formation reaches 15 cm or more. The abdomen is increasing, the organs are under pressure, reproductive dysfunction, dysfunctional uterine bleeding can be observed. Periodic pains in the abdomen, sacral area are noted. When an enlarged cyst begins to squeeze nearby organs, women can mark out digestive disorders, bladder, discomfort and soreness with sexual intercourse.

Functional ovarian cyst during pregnancy

Functional cysts include follicular formation and cyst of the yellow body. The size of such cysts can reach 80 mm. Small functional cysts tend to disappear independently, without presenting a danger to the body. Formations of large sizes can be twisted: this condition is considered critical and is accompanied by severe sharp pain in the cyst area. Signs of torsion are sometimes mistaken for an acute attack of appendicitis.

Dermoid ovarian cyst during pregnancy

The initial stages of development of the dermoid cyst usually do not have clinical symptoms. Symptoms appear when the cyst grows to 15 cm or more. The temperature may rise, weakness and pain in the abdomen may appear. The dermoid cyst usually does not promote hormonal failures and does not cause menstrual cycle disorders.

[9], [10], [11]

Retinal cyst of ovary during pregnancy

The retention cyst is not distinguished by certain characteristic features. Mostly, women complain of various soreness in the lower abdomen or a disorder of menstrual function. A vivid manifestation of the disease is observed only in case of complications: it is a torsion of the cyst or a hemorrhage into its cavity.

The cyst of the right ovary during pregnancy can be similar in symptomatology with an attack of acute appendicitis, inflammation of the lower segment of the ileum, as well as the ascending colon. Therefore, in this situation, it is extremely important to consult both a gynecologist and a surgeon. Cyst of the left ovary during pregnancy can occur almost asymptomatically, and in the presence of pain can resemble the symptoms of lesions of the transverse and sigmoid colon.

The localization of soreness can not always correspond to the location of the affected organ, therefore the examination of the patient should be as comprehensive as possible.

Consequences of ovarian cyst during pregnancy

If you managed to get pregnant, despite having a cyst - that's fine. However, a cyst must be constantly observed, periodically passing through ultrasound and visiting a gynecologist. The cyst can become dangerous when it begins to increase in volume: it disrupts the natural position of the appendages, can exert pressure on the uterus, creating prerequisites for spontaneous termination of pregnancy or premature onset of labor.

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

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

The risk of complications during labor is especially increased: intense contractions and excessive tension of the muscles of the anterior abdominal wall can lead to the rupture of cystic formation. In such cases, there is a need for immediate surgery, as 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 a woman, in which case she is simply watched without applying any measures. After childbirth, decide on the further treatment scheme.

[12], [13], [14]

Ovarian cyst rupture during pregnancy

The rapid growth of pathological cysts can pose a certain danger to the body. This can help twist the legs of the formation, increase the pressure inside the cyst and rupture it. Clinical signs begin with the appearance of acute soreness in the lower abdomen, which are expressed mainly from the affected side. Soreness accompanied by nausea, and often vomiting. A sudden jump in temperature, a quickening of the pulse. The blood shows leukocytosis, increased ESR.

With vaginal examination on the side and back of the uterus, soreness can be most intense.

The following symptoms are considered signs of a cyst rupture:

• the appearance of sudden sharp pains in the lower abdomen;
• a sharp temperature jump that can not be eliminated with conventional drugs;
• sudden weakness;
• vaginal discharge, including bloody;
• bouts of nausea;
• drop in blood pressure, dizziness, down to loss of consciousness.

The cyst erupts 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 the gynecologist regularly and monitor its development to avoid complications. If the tumor does not progress, and its dimensions are stable, it is simply observed. Remove the cyst, if desired, can be after the birth of the child. When complications develop, in severe situations, surgical intervention can be performed even during the pregnancy period: in the dominant majority of cases, specialists manage to save the life of both the mother and the baby.

Diagnosis of ovarian cysts during pregnancy

To detect cystic formation solely by symptomatology is rather difficult, since most cysts are asymptomatic. An exception may be the development of complications, when signs of the inflammatory process become apparent.

Many are wondering whether it is possible to detect the presence of a cyst with a pregnancy test. Of course not. Ovarian cyst and pregnancy test are not interrelated. If you have found a cyst, and the test parameter for pregnancy is positive - insist on giving a blood test for chorionic gonadotropin (beta-hCG). There are three reasons for this situation: either low-quality tests and "lie", or you are really pregnant with a cyst, or the cyst did not notice the development of an ectopic pregnancy. The earlier you pass the HCG analysis, the earlier measures will be taken to preserve your health, especially if it concerns an ectopic pregnancy.

Also describe a lot of cases when doctors have confused the ovarian cyst with pregnancy. From the medical point of view, this development is possible only in the last century. There is still the same analysis of hCG, which is carried out in dynamics, several times during the month. Cyst increase in hCG indices does not give, especially its progression! If you do not trust your doctor, change the specialist. The approach to diagnosis and treatment of patients should be individual, and not always one ultrasound is sufficient to make a diagnosis.

The main methods of diagnosing cysts are:

• Ultrasound using a transvaginal view;
• computer method of tomography of appendages;
• diagnostic laparoscopy.

These are the most informative methods for determining cysts. In addition, the doctor can prescribe a blood test for cancer markers, hormones, a general blood and urine test, bapsoseve, puncture biopsy.

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

[15], [16]

Treatment of ovarian cysts during pregnancy

Functional cystic formations, such as cystic formation of the yellow body and follicular cysts, in the vast majority of cases do not require surgical intervention. For cysts observed, controlling their growth on ultrasound. Most of the functional cysts eventually regress independently.

Operative intervention is subjected to those cysts that are pathological, or do not stop themselves during the three-month cycles. In addition, compulsory surgical treatment is subject to complicated cysts that reach large volumes, compressing surrounding tissues and organs, and, of course, twisted and ruptured formations.

Some doctors are inclined to believe that the danger of developing a functional cyst can be reduced by using contraceptive pills. In this there is a rational grain, because such drugs suppress ovulation. The most frequently prescribed drugs are Jeanine and Regulon. Tablets are taken once a day every day at the same time, the course of admission is usually 21 days. However, the doctor determines the duration of the treatment individually and, if necessary, can assign an additional course. The use of such treatment during pregnancy, of course, is contraindicated.

Removal of the ovarian cyst during pregnancy is usually performed only in case of emergency. Usually expect the birth of a child and only after that, if necessary, the cyst is removed. As a rule, removal is carried out by the method of laparoscopy, less often - laparotomy. With laparotomy, the anterior lining of the ligament of the uterus is dissected and the cyst is carefully harvested, limited 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, a prescription of pregnancy maintenance is mandatory.

Laparoscopy of ovarian cysts during pregnancy

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

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

Thanks to the laparoscope, the doctor can monitor the course of the operation, and also consider 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, a woman must necessarily pass a blood test, undergo ECG and fluorography, consult an anesthesiologist. The day before the operation, it is better not to take solid food, but for 10 hours not to eat or drink at all. The setting of a cleansing enema is possible on the eve and on the day of the operation.

A woman is usually discharged on the second or third day after laparoscopy, in the absence of complications. In the future, as a rule, the pregnant woman is kept for preservation in order to prevent possible consequences of the operation.

A possible contraindication to laparoscopic surgery may be:

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

The only drawback of laparoscopy can be called, perhaps, that by this operation it is possible to remove a cyst of not very large sizes, up to 6 cm in diameter. Cysts of considerable volumes are removed with the help of operative laparotomy.

Prevention of ovarian cysts during pregnancy

When preparing for conception, a woman should be fully examined, including an ultrasound examination for the presence of neoplasms. Therefore, such elements as cysts should be eliminated before pregnancy.

If a woman becomes pregnant without knowing about the existence of a cyst, you should regularly undergo a survey and monitor her growth. If the cyst does not bother, there is no need to touch it.

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

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 endure 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 take place for one reason or another, the unexploded follicle becomes a follicular cyst. It is believed that as long as there is a cyst (follicular or yellow body) in one of the ovaries, further growth of the follicles is impossible, therefore, ovulation will not occur. Such cysts will pass independently for 2 months, after which the 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: one cyst patient does not interfere with conception, the other - 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 self regress.