ovarian cyst with pregnancy

Posted by Kathryn Milstead on May 24, 1999 at 01:21:12
I had an HSG performed at the start of March.  We were told that everything was alright to try for a pregnancy.  We lost a pregnancy last July at 16 weeks. With no explanation for the loss so we have persued every avenue before trying again to be sure this pregnancy would be safe.
Later in March we became pregnant.  The clinic that performed the HSG did a Sonogram to verify our pregnancy at 5 weeks.  They found an Ovarian Cyst and told me not to worry.  They told me that they expected it to shrink on its own.  I went back for a follow up the next week.  I discovered that the cyst had a measurement of 3.5X5.2 cm.  I was told not to be conscerned.  The Dr. informed me that these Cysts are common and that they would either remain the same size or dissappear some time during term.  I was told the only danger was in the strangulation of the Cyst and there was nothing I could do to either prevent or encourage this to happen.  The next time I was seen it was a different dr. who told me that the Cyst will be gone by Second Trimester.  We had an Ultrasound at 11 weeks and the baby is fine, the heart rate is 167 and the size is 4.9 cm.  The Cyst however is now 5.3X7.9 cm.  The technician and Dr there checked on the blood flow, they said that there was no sign of strangulation, however they made no further comment.
I am getting a different story from each professional I talk to.  Those friends and family who "knew someone who went through this" only tell me that the pregnancy will have to be terminated.  I haven't heard anything towards that end from any Dr though.  I always feel as though the dr.s I deal with try to sugar coat the truth though.  Can you give me any insight as to what I might be dealing with.  I have searched the Web and can't seem to find any referenced to Ovarian Cysts during pregnancys.  Do I need to be concerned?
Thank you for your time,
Kathryn
Posted by hfhs.md.rcs on May 24, 1999 at 22:07:24
Dear Kathryn:
A 3.5 x 5.2 cm cyst is not unusual in early pregnancy: it is often the site of ovulation (corpus luteum) or a simple cyst from an egg unit that has accumulated fluid. There are also benign cysts that are incidentally discovered during pregnancy.
This cyst has not resolved: as you have been correctly told most cysts found in pregnancy do resolve. The common possibilities are that this is a persisting functional cyst that will resolve after pregnancy or one of the named ovarian cysts (for example dermoid cyst. In less than 5%, cysts in pregnancy of young women are ovarian tumors.
The ultrasound characteristics of the cyst are as important as the size of the cyst or its growth characteristics. This helps with the decision to continue to observe the cyst or to recommend cyst removal. If surgery is proposed, it is commonly done between the 13th and 20th weeks of pregnancy. Non-emergency surgery is postponed until after the first trimester and after 20 weeks, the size the uterus makes the surgery more challenging.
Ovarian cysts are not an indication to terminate a pregnancy.
Keywords: ovarian cyst in pregnancy
This information is provided for education purposes and is not a medical consultation. If you have specific questions, please speak with your healthcare provider.
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