title: Outcome of first-trimester fetal abdominal cysts: cohort study and review of the literature.
abstract: OBJECTIVE
  The aims of this study were to ascertain the outcome of fetuses with an abdominal cyst detected at 11-14 weeks' gestation in our unit and to undertake a review of cases reported in the literature.
  
  
  METHODS
  This was a retrospective study that included all fetuses found to have an abdominal cyst on ultrasound examination at 11-14 weeks, identified over a 14-year period. Pregnancy management and outcome were ascertained from maternal and neonatal records. We also performed a review of the literature using a systematic search strategy, to identify the outcome of similar cases and propose a management algorithm.
  
  
  RESULTS
  Fourteen cases were identified during the study period, of which four had associated abnormalities. Of the 10 isolated cases, the cyst had resolved at follow-up scan in eight (80.0%), one fetus died in utero at 15 weeks' gestation and the other case underwent surgery for a choledochal cyst 9 weeks after birth. An additional 19 cases were reported in the literature. In eight fetuses there were associated structural abnormalities, of which four had a diagnosis of anorectal malformation after birth. In two of these four, the cyst resolved in the second trimester. Of those cases with an isolated cyst (n = 11), the cyst resolved in seven (63.6%). The remainder were variably diagnosed as hepatic cyst, ileal duplication or choledochal cyst.
  
  
  CONCLUSIONS
  Fetal abdominal cysts at 11-14 weeks' gestation are rare. They constitute an isolated finding in the majority of cases and are usually associated with a good perinatal outcome. In view of the reported association with anorectal and other gastrointestinal malformations, perinatal assessment is recommended, even if the cyst resolves during pregnancy.
authors.affiliation: Fetal Medicine Unit, Academic Department of Obstetrics and Gynaecology, St George's University of London, London, UK.
authors.forename: A
authors.initials: A
authors.lastname: Khalil
authors.forename: P C
authors.initials: PC
authors.lastname: Cooke
authors.forename: E
authors.initials: E
authors.lastname: Mantovani
authors.forename: A
authors.initials: A
authors.lastname: Bhide
authors.forename: A T
authors.initials: AT
authors.lastname: Papageorghiou
authors.forename: B
authors.initials: B
authors.lastname: Thilaganathan
mesh_terms: D000005:Abdomen / Q000000981:diagnostic imaging / Q000196:embryology*; D000328:Adult; D015331:Cohort Studies; D003560:Cysts / Q000000981:diagnostic imaging / Q000196:embryology*; D005260:Female; D005315:Fetal Diseases / Q000000981:diagnostic imaging / Q000473:pathology*; D006801:Humans; D011247:Pregnancy; D011256:Pregnancy Outcome; D011261:Pregnancy Trimester, First; D012189:Retrospective Studies; D016896:Treatment Outcome; D016216:Ultrasonography, Prenatal
keywords: abdominal; cyst; first-trimester; prenatal diagnosis; screening; ultrasound