Montaguti Elisa, Petrachi Benedetta, Fiorentini Marta, Arosio Viola, Doroldi Sara, Dionisi Camilla, Bernardi Vito, Pilu Gianluigi
Obstetric Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Via Massarenti 13, 40138 Bologna, Italy.
Diagnostics (Basel). 2024 Dec 4;14(23):2726. doi: 10.3390/diagnostics14232726.
The aim of this study was to evaluate prenatal ultrasound features, fetal postnatal outcomes, and the need for postnatal surgery in the suspicion of ovarian torsion. We included patients with a singleton pregnancy with a suspicion of ovarian fetal cyst referred to our center. Data derived from prenatal ultrasound evaluations, delivery, and postnatal follow-up were then extracted from the hospital registers. The ultrasound features of 32 fetal ovarian cysts and related neonatal outcomes were analyzed. The mean gestational age at diagnosis was 32 weeks (28-36), while the mean diameter of the cyst diagnosis was 34.8 ± 13.2 mm. In 78.1% of cases, the cysts did not change their characteristics during pregnancy, while in 9.4%, they increased their dimensions, and in 12.5%, they reduced their size. In 78.1% of cases, the diagnosis was confirmed postnatally, and in 40% of cases, a spontaneous regression occurred during follow-up. Surgery was performed in 60% of cases, and most of the time (66.7%), an adnexectomy was required. An unfavorable outcome was associated with cystic dimensions and ultrasound feature modifications during pregnancy. However, our study demonstrated that a hemorrhagic content is not always indicative of adnexal torsion, and spontaneous resolution may occur. In addition, only a few of the simple anechoic cysts managed surgically presented with necrosis at histopathological examination; therefore, a conservative approach might be proposed in those cases.
本研究的目的是评估产前超声特征、胎儿出生后结局以及疑似卵巢扭转时产后手术的必要性。我们纳入了单胎妊娠且疑似胎儿卵巢囊肿并转诊至本中心的患者。然后从医院登记册中提取产前超声评估、分娩及产后随访的数据。分析了32例胎儿卵巢囊肿的超声特征及相关新生儿结局。诊断时的平均孕周为32周（28 - 36周），而囊肿诊断时的平均直径为34.8±13.2毫米。在78.1%的病例中，囊肿在孕期特征未改变，9.4%的病例囊肿尺寸增大，12.5%的病例囊肿尺寸减小。78.1%的病例产后确诊，40%的病例在随访期间自发消退。60%的病例进行了手术，大多数情况下（66.7%）需要行附件切除术。不良结局与孕期囊肿尺寸及超声特征改变有关。然而，我们的研究表明，囊内出血并不总是提示附件扭转，且可能会自发消退。此外，手术治疗的单纯无回声囊肿中，只有少数在组织病理学检查时出现坏死；因此，对于这些病例可采取保守治疗方法。
