title: Fetal ovarian cysts management and ovarian prognosis: a report of 82 cases.
abstract: OBJECTIVE
  Fetal ovarian cysts are frequently complicated by intracystic hemorrhage without associated clinical signs, which is often secondary to ovarian torsion leading to loss of the ovary. The aim of this study was to evaluate ovarian outcome and the place of prenatal management and surgery in the first few days of life in order to save the ovary.
  
  
  METHODS
  Between January 1987 and June 2006, 82 fetal ovarian cysts in 79 patients were managed and clinically and ultrasonographically followed up for several months (median, 11 months; range, 6 months to 10 years) in all of the cases where the ovary was not removed. The ultrasonographic results regarding the ovarian parenchyma were broken down into 3 categories: follicular ovary, homogeneous ovary, and undetected ovary.
  
  
  RESULTS
  Twenty-seven cysts remained simple throughout their evolution, and 55 were complicated by intracystic hemorrhage usually several weeks before birth. Overall, after disappearance of the cyst, a follicular ovary was detected in only 39% of the cases (32/82) and more often when the cyst was simple than when it presented an intracystic hemorrhage (85% vs 16.4%, chi(2), P < .0001).
  
  
  CONCLUSIONS
  A review of our series confirms the poor ovarian outcome linked to ultrasonographic signs of intracystic hemorrhage. Preventive action by puncture of "simple" cysts is still being studied. The presence of a bilateral cyst can, if pulmonary maturity has been reached, be an argument for inducement of premature birth with a view to performing conservative surgery. After birth, surgery in the first few days of life is only justified if the signs of intracystic hemorrhage appeared in the period very close to birth.
authors.affiliation: Department of Pediatric Surgery, Children's Hospital, TSA 70034, 31059 Toulouse Cedex 9, France.
authors.forename: Philippe
authors.initials: P
authors.lastname: Galinier
authors.forename: Luana
authors.initials: L
authors.lastname: Carfagna
authors.forename: Michel
authors.initials: M
authors.lastname: Juricic
authors.forename: Frederique
authors.initials: F
authors.lastname: Lemasson
authors.forename: Jacques
authors.initials: J
authors.lastname: Moscovici
authors.forename: Jacques
authors.initials: J
authors.lastname: Guitard
authors.forename: Christiane
authors.initials: C
authors.lastname: Baunin
authors.forename: Marcella
authors.initials: M
authors.lastname: Menendez
authors.forename: Audrey
authors.initials: A
authors.lastname: Cartault
authors.forename: Catherine
authors.initials: C
authors.lastname: Pienkowski
authors.forename: Sylvie
authors.initials: S
authors.lastname: Kessler
authors.forename: Marie-France
authors.initials: MF
authors.lastname: Sarramon
authors.forename: Philippe
authors.initials: P
authors.lastname: Vaysse
mesh_terms: D005260:Female; D005500:Follow-Up Studies; D005865:Gestational Age; D006470:Hemorrhage / Q000209:etiology / Q000601:surgery; D006801:Humans; D007231:Infant, Newborn; D010048:Ovarian Cysts / Q000150:complications / Q000000981:diagnostic imaging / Q000196:embryology* / Q000473:pathology / Q000601:surgery; D010052:Ovariectomy / Q000379:methods; D011677:Punctures; D012189:Retrospective Studies; D014463:Ultrasonography; D019564:Unnecessary Procedures