Meagher S E, Fisk N M, Boogert A, Russell P
Department of Fetal Medicine, Royal Prince Alfred Hospital, Camperdown, N.S.W., Australia.
Fetal Diagn Ther. 1993 May-Jun;8(3):195-9. doi: 10.1159/000263824.
Antenatal diagnoses of fetal ovarian cysts have not usually been confirmed until postnatal surgery. We describe 2 cases of hemorrhage into fetal ovarian cysts in which cyst aspiration in utero allowed both confirmation of the diagnosis prenatally and obviated the need for neonatal surgery. In both cases, cytology of the cyst aspirate demonstrated luteinized granulosa cells and biochemistry showed estradiol levels of > 10,000 pmol/l, indicating ovarian etiology. Hemorrhage, which had been suspected on ultrasound, was confirmed by cytology, showing hemosiderin-laden macrophages. There was no evidence of recurrence in either case following aspiration. The described association of fetal hypothyroidism was excluded by testing thyroid function in cord blood and/or cyst aspirate. We suggest that intrauterine aspiration contributes to the management of fetal ovarian cysts by confirming their ovarian origin, demonstrating the presence or absence of hemorrhage and facilitating preservation of ovarian function both by reducing the risk of torsion and the need for neonatal surgery.
胎儿卵巢囊肿的产前诊断通常要到产后手术时才能得到证实。我们描述了2例胎儿卵巢囊肿出血的病例，其中子宫内囊肿抽吸术不仅在产前确诊了疾病，还避免了新生儿手术的需要。在这两例病例中，囊肿抽吸物的细胞学检查显示有黄素化颗粒细胞，生化检查显示雌二醇水平>10,000 pmol/l，提示为卵巢来源。超声检查怀疑有出血，经细胞学检查证实，可见含铁血黄素巨噬细胞。抽吸术后两例均无复发迹象。通过检测脐血和/或囊肿抽吸物中的甲状腺功能，排除了所描述的胎儿甲状腺功能减退的关联。我们认为，子宫内抽吸术有助于胎儿卵巢囊肿的管理，通过确认其卵巢来源，显示有无出血，并通过降低扭转风险和新生儿手术需求来促进卵巢功能的保留。
