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Ovarian cyst and 37weeks pregnant
I am 37 weeks pregnant and have a 15 cm cyst on my ovary. The cyst twisted once which was extremely painful and it has caused me much pain in day to day life. I am wondering about asking for a csection to deliver the baby and remove the cyst. Anyone had experience with this?
I know this post is from a long time ago, but how did your deliveries go?
I am 36 weeks pregnant and have a 23cmx11cm ovarian cyst. I consulted with 3 different doctors. My favorite option was to try to delivery naturally & have it laparoscopically removed after, but my baby is breech. So the new plan is to have a vertical incision in my abdomen, horizontal c-section, remove the cyst, ovary, & fallopian tube, and have a frozen section done to check for cancer before stitching me up, all while using a spinal & epidural so I can remain conscious for the birth of our child. Mine didn't get that large until it grew suddenly around 30 weeks, so it was too late for a 2nd trimester intervention. Would love to know how yours went!
I am 36 weeks pregnant and have a 23cmx11cm ovarian cyst. I consulted with 3 different doctors. My favorite option was to try to delivery naturally & have it laparoscopically removed after, but my baby is breech. So the new plan is to have a vertical incision in my abdomen, horizontal c-section, remove the cyst, ovary, & fallopian tube, and have a frozen section done to check for cancer before stitching me up, all while using a spinal & epidural so I can remain conscious for the birth of our child. Mine didn't get that large until it grew suddenly around 30 weeks, so it was too late for a 2nd trimester intervention. Would love to know how yours went!
7 Comments
I am sorry you are dealing with this. At least you are close to full term. Was removal of just the cyst / cystectomy (versus the ovary and tube) discussed at all? Chances are great that the cyst is benign (especially if you don't have a family history of ovarian cancer). Even though it is large, a surgeon with good cystectomy skills may very well be able to save your ovary or enough of it for its health promoting and fertility functions. Far too many women lose an ovary or ovaries for benign ovarian cysts when that is not necessary. Studies show that removal of even one ovary increases risk for some health related problems (aside from impaired fertility). This site states that cystectomy is almost always possible - http://ovaryresearch.com/ovarian_cysts.htm.
Do you have a copy of your imaging report that describes the cyst?
Do you have a copy of your imaging report that describes the cyst?
Yes! Thanks for responding, it's such an old thread I didn't know what to expect :)
IMPRESSION: Cystic left adnexal mass measuring up to 24 cm shows no definite
internal fat or hemorrhage. Given composition and growth from 2015, it is
suspicious for epithelial neoplasm and the complex, solid-appearing internal
components including thickened septations and peripheral mural nodules are
suspicious for malignancy. No adenopathy or peritoneal disease in the pelvis by
noncontrast MR although the gravid uterus limits evaluation. Pregnancy precludes
administration of gadolinium contrast/confirmation of solid enhancing
components. Comparison to ultrasound with Doppler may be beneficial.
Complex cystic left adnexal mass 15 x 12 x 24 cm extending from the low pelvis
So they said that even though it is suspicious, it's more than likely benign because of my age (32). Everyone has said it'd be really hard, if not impossible, to save the ovary at this point though... but that's something that will be more clear during the surgery. Thanks for the link!
IMPRESSION: Cystic left adnexal mass measuring up to 24 cm shows no definite
internal fat or hemorrhage. Given composition and growth from 2015, it is
suspicious for epithelial neoplasm and the complex, solid-appearing internal
components including thickened septations and peripheral mural nodules are
suspicious for malignancy. No adenopathy or peritoneal disease in the pelvis by
noncontrast MR although the gravid uterus limits evaluation. Pregnancy precludes
administration of gadolinium contrast/confirmation of solid enhancing
components. Comparison to ultrasound with Doppler may be beneficial.
Complex cystic left adnexal mass 15 x 12 x 24 cm extending from the low pelvis
So they said that even though it is suspicious, it's more than likely benign because of my age (32). Everyone has said it'd be really hard, if not impossible, to save the ovary at this point though... but that's something that will be more clear during the surgery. Thanks for the link!
Is a gynecologic oncologist removing it since there is a possibility (albeit small) of malignancy?
Yes, a gynecological oncologist & ob/gyn will perform the surgery. They will do a frozen section during and stage me then if need be. Hopefully it's not necessary, but I'd rather deal with everything at once than have multiple operations. We have a toddler also, so I'm trying to wrap my head around what recovery will be like with him & a newborn after this c-section/cyst/ovary/tube removal... Probably not easy!
I hope all goes well, it is benign, and you have some help during recovery. It is hard enough with a newborn and toddler. Please post back and let us know the biopsy results and how you and your baby (and family) are doing. I will be thinking of you.
Surgery follow up, to help others out there who may be looking for our similar (very rare) cases:
Mu son was born via c-section at 39 weeks (big healthy boy) and right after the mucinous ovarian cyst, which grew to over 30 cm, was removed and a frozen section performed to determine if it was malignant. It came back borderline and the fallopian tube was also removed and I was put under general anesthesia and staged. There was fluid in my abdomen to sample but lymph nodes are not needed for this type of cyst. Additional pathology revealed that a small part of the giant cyst was mucinous adenocarcinoma, but the fluid and additional areas checked were benign, so cancer stage IC. Because mucinous cancer doesn't respond incredibly well to chemo and it appears to be contained I may not do chemo, waiting on a recommendation from the hospitals' tumor board. The cancer is low grade. They will be checking my GI tract for signs that the cancer originated there because it is mucinous type. That is my main concern. Otherwise they may have gotten it all already.
Recovery from the c-section and laparotomy/sapalingo-oophrectomy was rough the first 2-3 days, but better by the 4th and much better by the 5th. Made worse by bad sleep with an infant and better by tapering off the pain killers to get my digestive system going again. I get around today, a week post surgery, better than I did before with the extra 40 lbs of baby & cyst, and very glad we did it the way we did and wouldn't change anything. Our doctors were fantastic, and saved my other ovary and uterus for future children and are taking that into account. I would go to the best hospital you can go to for this, it takes a lot of interdisciplinary coordination. This is a rare type of ovarian cancer at a young age, but hopefully this helps someone out there.
Mu son was born via c-section at 39 weeks (big healthy boy) and right after the mucinous ovarian cyst, which grew to over 30 cm, was removed and a frozen section performed to determine if it was malignant. It came back borderline and the fallopian tube was also removed and I was put under general anesthesia and staged. There was fluid in my abdomen to sample but lymph nodes are not needed for this type of cyst. Additional pathology revealed that a small part of the giant cyst was mucinous adenocarcinoma, but the fluid and additional areas checked were benign, so cancer stage IC. Because mucinous cancer doesn't respond incredibly well to chemo and it appears to be contained I may not do chemo, waiting on a recommendation from the hospitals' tumor board. The cancer is low grade. They will be checking my GI tract for signs that the cancer originated there because it is mucinous type. That is my main concern. Otherwise they may have gotten it all already.
Recovery from the c-section and laparotomy/sapalingo-oophrectomy was rough the first 2-3 days, but better by the 4th and much better by the 5th. Made worse by bad sleep with an infant and better by tapering off the pain killers to get my digestive system going again. I get around today, a week post surgery, better than I did before with the extra 40 lbs of baby & cyst, and very glad we did it the way we did and wouldn't change anything. Our doctors were fantastic, and saved my other ovary and uterus for future children and are taking that into account. I would go to the best hospital you can go to for this, it takes a lot of interdisciplinary coordination. This is a rare type of ovarian cancer at a young age, but hopefully this helps someone out there.
Congrats on a healthy boy! I am sorry your cyst ended up being malignant but glad it was caught early and they seem to have gotten all of it. (Mine was also mucinous but benign.) I am glad your recovery is progressing and wish you the best of health and happiness.
Hi ya,
I pushed for a c-section. My doctors wanted me to get it out after delivery. I had to go to a gyn/oncologist to get their opinion. This scared me to death because of course you immediately think cancer but she is pretty confident it is not. However, she did tell my OBs that she would assist with the c-section because she feels is would be the best decision to take a cyst that large out asap. the possibility of twisting after there is more room for it to move is great.
As for as I know, I will receive an epidural and it is the hopes of my doc to get the c-section and cyst removal done under that. Of course, they had to tell me all the other possibilities if this is more than just a large simple cyst. I might lose my ovary b/c of how large the cyst is. If there are other complications, I may be put under but I am trying to think the best.
I have never had a cyst either that I know of. It has to be from the pregnancy hormones...it is just so frustrating. I understand your pain. I have been in so much pain on and off b/c of the size of this thing!! You are so far along, if you weren't I'd request you getting a second opinion regarding a c-section. But-the cyst might shrink after you give birth and you will have a much easier surgery/recovery than me.
My surgery/c-section is on Friday, 6/17....They are taking him early bc of my pain. I will be 38 weeks.
I pushed for a c-section. My doctors wanted me to get it out after delivery. I had to go to a gyn/oncologist to get their opinion. This scared me to death because of course you immediately think cancer but she is pretty confident it is not. However, she did tell my OBs that she would assist with the c-section because she feels is would be the best decision to take a cyst that large out asap. the possibility of twisting after there is more room for it to move is great.
As for as I know, I will receive an epidural and it is the hopes of my doc to get the c-section and cyst removal done under that. Of course, they had to tell me all the other possibilities if this is more than just a large simple cyst. I might lose my ovary b/c of how large the cyst is. If there are other complications, I may be put under but I am trying to think the best.
I have never had a cyst either that I know of. It has to be from the pregnancy hormones...it is just so frustrating. I understand your pain. I have been in so much pain on and off b/c of the size of this thing!! You are so far along, if you weren't I'd request you getting a second opinion regarding a c-section. But-the cyst might shrink after you give birth and you will have a much easier surgery/recovery than me.
My surgery/c-section is on Friday, 6/17....They are taking him early bc of my pain. I will be 38 weeks.
it was discovered at christmas so when i was about 2 months pregnant. I had no idea it was there until i went to hospital with agonizing abdominal pain and they did an ultrasound and found the cyst (it was about 12 cm at the time) and it had twisted which is why i was in so much ain it didn't really change in size until this last month it grew by another 3 cm. I don't know if i had it before i was pregnant. The OBGYN i saw in emergency told me it was caused by the pregnancy, i've never had one before that i know of but from my understanding smaller ones can be quite common and most women don't know they are even there.
i def. understand the need to "get it out of me" it's been 6 long months of pain and limited acitivty with this cyst.
sassygirlj did you dr say you recovery would be worse than regular C section with having the cyst removed too?
i def. understand the need to "get it out of me" it's been 6 long months of pain and limited acitivty with this cyst.
sassygirlj did you dr say you recovery would be worse than regular C section with having the cyst removed too?
I completely understand where you are coming from. I pushed for a c-section because I would have to come back 4-6 weeks later. I just couldn't deal with the thought of this thing in me any longer. It has started to be a bit more uncomfortable due to the size. Has yours grown throughout your pregnancy? When was it found? I know I didn't have mine prior to becoming pregnant because I was monitored closely due to fertility treatment. It is on the same ovary that I ovulated from. Could you ask your doctor about possible c/s?
Mine is fluid filled also. Nothing to worry about long term. My dr would prefer me to go through natural labour and have the cyst removed lapriscopically sat a later date. But my dr is a 2 hour drive away and I am not stoked about having to recover from labour to then have another surgery. Just want to get back to normal.
Hi-
I have a cyst around the same size. I am having a c-section next Friday at 38 weeks as well as removing the cyst. I would def. ask your obgyn about it. What kind of cyst is it? Mine is just fluid-filled but I am still absolutely nervous about the outcome!
I have a cyst around the same size. I am having a c-section next Friday at 38 weeks as well as removing the cyst. I would def. ask your obgyn about it. What kind of cyst is it? Mine is just fluid-filled but I am still absolutely nervous about the outcome!
There has been someone who is pregnant that had the surgery while pregnant, but not sure if there is anyone who has dealt with it that far along in pregnancy. It would be something to talk to the OBGYN for sure, especially if the cyst has twisted, you need to make sure that the the ovary is still okay and that it hasnt damaged it. Good luck with the cyst. And congrats on the little one!
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