Perrotin F, Roy F, Potin J, Lardy H, Lansac J, Body G
Département Gynécologie Obstétrique, Médecine Foetale et Reproduction Humaine.
J Gynecol Obstet Biol Reprod (Paris). 2000 Apr;29(2):161-9.
To evaluate the outcome of fetal ovarian cysts in relation to their ultrasonic appearance and size. To define, on that basis, the contribution of intrauterine aspiration.
Retrospective study of all ovarian fetal cysts detected by prenatal ultrasound examination (n = 25) during a 4 year period. All these cysts were followed during pregnancy and after delivery until spontaneous or surgical resolution.
At the time of prenatal sonographic detection at the mean gestational age of 32 1/2 weeks, the mean cyst diameter was 43+/-17 mm and 36% of all these cysts were already complicated (fluid-debris level, septa or finding of a retracting clot). Among the 16 non-complicated cysts (echolucent and thin-walled) 44% became twisted during the perinatal period irrespective of the size or the time of discovery. At birth, all these complicated cysts underwent surgical treatment and needed oophorectomy or adnexectomy. Surgery was therefore performed in a total of 56% of neonates. The pathologic reports confirm in all cases the benign follicular or follicular lutein nature of the cysts.
Due to this high rate of mechanical complications, cyst decompression may be considered at the time of diagnosis in case of an anechoic fetal ovarian cyst. The safety and efficacy of this approach, on the cases reported in the literature seem encouraging. Although, a prospective randomized evaluation is needed.
评估胎儿卵巢囊肿的转归与超声表现及大小的关系。在此基础上，明确宫内抽吸的作用。
对4年间产前超声检查发现的所有胎儿卵巢囊肿（n = 25）进行回顾性研究。所有这些囊肿在孕期及产后均进行随访，直至自然消退或手术解决。
在产前超声检查时，平均孕周为32.5周，囊肿平均直径为43±17 mm，所有这些囊肿中有36%已出现并发症（液性-实性分层、分隔或发现回缩性血凝块）。在16个无并发症的囊肿（无回声且壁薄）中，44%在围产期发生扭转，与大小或发现时间无关。出生时，所有这些有并发症的囊肿均接受了手术治疗，需要进行卵巢切除术或附件切除术。因此，共有56%的新生儿接受了手术。病理报告在所有病例中均证实囊肿具有良性滤泡或滤泡黄体性质。
由于机械性并发症发生率高，对于无回声胎儿卵巢囊肿，在诊断时可考虑进行囊肿减压。就文献报道的病例而言，这种方法的安全性和有效性似乎令人鼓舞。不过，仍需要进行前瞻性随机评估。
