Perinatal outcomes of fetal abdominal cysts and comparison of prenatal and postnatal diagnoses.
BACKGROUND
The differential diagnosis of an abdominal cyst can be challenging, and an accurate diagnosis is crucial for optimal antenatal management. The aim of this study was to compare the ante- and postnatal diagnoses of cases with abdominal cyst and to determine the diagnostic accuracy of ultrasonography.


METHODS
A database review was performed regarding the diagnosis of fetal abdominal cyst covering the period 2002-2009. Structural characteristics and localizations of the cysts in the abdomen were recorded. Ante- and postnatal diagnoses were classified into systems according to the origin of the cyst and were compared. Perinatal outcomes were obtained for all cases.


RESULTS
71 cases with an abdominal cyst were identified. The mean gestational age at the time of diagnosis was 25 ± 5.1 weeks. In 9 cases, there were extra-fetal structural abnormalities, and in 5 cases a chromosomal abnormality was determined. Seven pregnancies were terminated. Overall spontaneous mortality was 11/64 (17%). In 12/64 cases (18%), the cyst resolved at birth. After birth, nearly half of the cases required surgical correction and of these, 20% died. Sensitivity, specificity and positive predictive value of ultrasonography in identifying the system of origin were 88.1, 95.7 and 92.0%, respectively, with a 4.1% false-positive rate.


CONCLUSIONS
Incorporation of different disciplines in the counseling, management and postpartum follow-up is crucial. Postnatal physical examination of fetuses with an abdominal cyst will help to prevent unnecessary surgery.
Ozyuncu
Ozgur
O
Department of Obstetrics and Gynecology, Hacettepe University, Ankara, Turkey. ozyuncu@hacettepe.edu.tr
Canpolat
Fuat Emre
FE
Ciftci
Arbay Ozden
AO
Yurdakok
Murat
M
Onderoglu
Lutfu S
LS
Deren
Ozgur
O
D000005:Abdomen / Q000000981:diagnostic imaging*; D000328:Adult; D002869:Chromosome Aberrations; D003560:Cysts / Q000000981:diagnostic imaging* / Q000401:mortality / Q000601:surgery; D003937:Diagnosis, Differential; D005260:Female; D005315:Fetal Diseases / Q000000981:diagnostic imaging* / Q000401:mortality / Q000601:surgery; D046689:Fetal Mortality; D005865:Gestational Age; D006801:Humans; D007226:Infant Mortality; D007231:Infant, Newborn; D008297:Male; D018743:Perinatal Care; D011247:Pregnancy; D011256:Pregnancy Outcome; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D016216:Ultrasonography, Prenatal