Prenatal Aspiration of Fetal Ovarian Cysts: When to Intervene? A Case Report and Review of the Literature

Fetal adnexal cysts present unique challenges during pregnancy, requiring careful management strategies to mitigate risks throughout gestation and delivery. We present the case of a 35-year-old G4P2 patient, referred to our center for a large adnexal cyst confirmed by ultrasound (US) and fetal MRI,...

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Main Authors: Giulia Bonanni, Scott A. Shainker, Eyal Krispin, Ryne A. Didier, Terry L. Buchmiller, Alireza A. Shamshirsaz
Format: Article
Language:English
Published: Thieme Medical Publishers, Inc. 2025-04-01
Series:American Journal of Perinatology Reports
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Online Access:http://www.thieme-connect.de/DOI/DOI?10.1055/a-2562-1898
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author Giulia Bonanni
Scott A. Shainker
Eyal Krispin
Ryne A. Didier
Terry L. Buchmiller
Alireza A. Shamshirsaz
author_facet Giulia Bonanni
Scott A. Shainker
Eyal Krispin
Ryne A. Didier
Terry L. Buchmiller
Alireza A. Shamshirsaz
author_sort Giulia Bonanni
collection DOAJ
description Fetal adnexal cysts present unique challenges during pregnancy, requiring careful management strategies to mitigate risks throughout gestation and delivery. We present the case of a 35-year-old G4P2 patient, referred to our center for a large adnexal cyst confirmed by ultrasound (US) and fetal MRI, with a calculated volume of 210 mL. Given the cyst's size and the family's strong preference for vaginal delivery (VD), US-guided aspiration was performed at 356/7 weeks, followed by an uncomplicated spontaneous VD at 372/7 weeks. Two weeks postpartum, the ovarian cyst re-accumulated, requiring laparoscopic-assisted cystectomy in a torsed but viable left ovary. This case demonstrates the importance of individualized prenatal care, where clinical decisions balance parental preferences with medical risks. Maximizing the opportunity for vaginal birth was a top priority for the family, and the successful reduction of the cyst's size through percutaneous aspiration minimized the risk of abdominal dystocia and allowed for a safe VD. We review relevant literature, emphasizing the need for further research to refine fetal intervention criteria and improve outcomes for such cases.
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language English
publishDate 2025-04-01
publisher Thieme Medical Publishers, Inc.
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series American Journal of Perinatology Reports
spelling doaj-art-9d4dcada5cdf438b9f4bbe1b441927652025-08-20T02:03:16ZengThieme Medical Publishers, Inc.American Journal of Perinatology Reports2157-69982157-70052025-04-011502e58e6110.1055/a-2562-1898Prenatal Aspiration of Fetal Ovarian Cysts: When to Intervene? A Case Report and Review of the LiteratureGiulia Bonanni0https://orcid.org/0000-0003-3044-238XScott A. Shainker1https://orcid.org/0000-0002-6062-6772Eyal Krispin2Ryne A. Didier3Terry L. Buchmiller4Alireza A. Shamshirsaz5Division of Fetal Medicine and Surgery, Fetal Care and Surgery Center, Boston Children's Hospital, Harvard Medical School, Boston, MassachusettsDepartment of Obstetrics and Gynecology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MassachusettsDivision of Fetal Medicine and Surgery, Fetal Care and Surgery Center, Boston Children's Hospital, Harvard Medical School, Boston, MassachusettsDivision of Fetal Medicine and Surgery, Fetal Care and Surgery Center, Boston Children's Hospital, Harvard Medical School, Boston, MassachusettsDepartment of Surgery, Boston Children's Hospital, Boston, MassachusettsDivision of Fetal Medicine and Surgery, Fetal Care and Surgery Center, Boston Children's Hospital, Harvard Medical School, Boston, MassachusettsFetal adnexal cysts present unique challenges during pregnancy, requiring careful management strategies to mitigate risks throughout gestation and delivery. We present the case of a 35-year-old G4P2 patient, referred to our center for a large adnexal cyst confirmed by ultrasound (US) and fetal MRI, with a calculated volume of 210 mL. Given the cyst's size and the family's strong preference for vaginal delivery (VD), US-guided aspiration was performed at 356/7 weeks, followed by an uncomplicated spontaneous VD at 372/7 weeks. Two weeks postpartum, the ovarian cyst re-accumulated, requiring laparoscopic-assisted cystectomy in a torsed but viable left ovary. This case demonstrates the importance of individualized prenatal care, where clinical decisions balance parental preferences with medical risks. Maximizing the opportunity for vaginal birth was a top priority for the family, and the successful reduction of the cyst's size through percutaneous aspiration minimized the risk of abdominal dystocia and allowed for a safe VD. We review relevant literature, emphasizing the need for further research to refine fetal intervention criteria and improve outcomes for such cases.http://www.thieme-connect.de/DOI/DOI?10.1055/a-2562-1898fetal adnexal cystultrasound-guided aspirationfetal interventionindividualized prenatal careprenatal diagnosis
spellingShingle Giulia Bonanni
Scott A. Shainker
Eyal Krispin
Ryne A. Didier
Terry L. Buchmiller
Alireza A. Shamshirsaz
Prenatal Aspiration of Fetal Ovarian Cysts: When to Intervene? A Case Report and Review of the Literature
American Journal of Perinatology Reports
fetal adnexal cyst
ultrasound-guided aspiration
fetal intervention
individualized prenatal care
prenatal diagnosis
title Prenatal Aspiration of Fetal Ovarian Cysts: When to Intervene? A Case Report and Review of the Literature
title_full Prenatal Aspiration of Fetal Ovarian Cysts: When to Intervene? A Case Report and Review of the Literature
title_fullStr Prenatal Aspiration of Fetal Ovarian Cysts: When to Intervene? A Case Report and Review of the Literature
title_full_unstemmed Prenatal Aspiration of Fetal Ovarian Cysts: When to Intervene? A Case Report and Review of the Literature
title_short Prenatal Aspiration of Fetal Ovarian Cysts: When to Intervene? A Case Report and Review of the Literature
title_sort prenatal aspiration of fetal ovarian cysts when to intervene a case report and review of the literature
topic fetal adnexal cyst
ultrasound-guided aspiration
fetal intervention
individualized prenatal care
prenatal diagnosis
url http://www.thieme-connect.de/DOI/DOI?10.1055/a-2562-1898
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