Transvaginal Ovarian Cyst Drainage in Third Trimester to Facilitate Vaginal Delivery
Adnexal masses in the third trimester of pregnancy may obstruct the pelvic outlet precluding labor induction and vaginal delivery. Expectant versus surgical management of adnexal cysts in pregnancy must carefully weigh maternal–fetal benefits and risks. Simple benign appearing cysts with low likelih...
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| Published in | American journal of perinatology reports Vol. 13; no. 4; pp. e82 - e84 |
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| Main Authors | , , , , , |
| Format | Journal Article |
| Language | English |
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01.07.2023
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| Abstract | Adnexal masses in the third trimester of pregnancy may obstruct the pelvic outlet precluding labor induction and vaginal delivery. Expectant versus surgical management of adnexal cysts in pregnancy must carefully weigh maternal–fetal benefits and risks. Simple benign appearing cysts with low likelihood of malignancy may be amenable to percutaneous drainage as a bridge to interval postpartum laparoscopic cystectomy. We demonstrated posterior culdocentesis as a safe, minimally invasive technique to decompress a simple benign appearing left adnexal cyst obstructing the pelvic outlet in the third trimester at the time of labor induction to facilitate vaginal delivery and prevent primary cesarean delivery. Detailed sonographic cyst evaluation and counseling on underlying risk of malignancy must be considered to guide shared decision-making. |
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| AbstractList | Adnexal masses in the third trimester of pregnancy may obstruct the pelvic outlet precluding labor induction and vaginal delivery. Expectant versus surgical management of adnexal cysts in pregnancy must carefully weigh maternal–fetal benefits and risks. Simple benign appearing cysts with low likelihood of malignancy may be amenable to percutaneous drainage as a bridge to interval postpartum laparoscopic cystectomy. We demonstrated posterior culdocentesis as a safe, minimally invasive technique to decompress a simple benign appearing left adnexal cyst obstructing the pelvic outlet in the third trimester at the time of labor induction to facilitate vaginal delivery and prevent primary cesarean delivery. Detailed sonographic cyst evaluation and counseling on underlying risk of malignancy must be considered to guide shared decision-making. |
| Author | Rhee, Eleanor H. J. Kuller, Jeffrey A. Kerner, Nicole P. Avram, Carmen M. Wheeler, Sarahn M. Meljen, Vivienne T. |
| AuthorAffiliation | 1 Department of Obstetrics and Gynecology, Duke University Health System, Durham, North Carolina 3 Division of Women and Community Population Health, Department of Obstetrics and Gynecology, Duke University Health System, Durham, North Carolina 2 Department of Obstetrics and Gynecology, Washington State University Elson S. Floyd School of Medicine, Spokane, Washington 4 Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Duke University Health System, Durham, North Carolina |
| AuthorAffiliation_xml | – name: 4 Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Duke University Health System, Durham, North Carolina – name: 1 Department of Obstetrics and Gynecology, Duke University Health System, Durham, North Carolina – name: 3 Division of Women and Community Population Health, Department of Obstetrics and Gynecology, Duke University Health System, Durham, North Carolina – name: 2 Department of Obstetrics and Gynecology, Washington State University Elson S. Floyd School of Medicine, Spokane, Washington |
| Author_xml | – sequence: 1 givenname: Vivienne T. surname: Meljen fullname: Meljen, Vivienne T. organization: Department of Obstetrics and Gynecology, Duke University Health System, Durham, North Carolina, Department of Obstetrics and Gynecology, Washington State University Elson S. Floyd School of Medicine, Spokane, Washington – sequence: 2 givenname: Carmen M. surname: Avram fullname: Avram, Carmen M. organization: Department of Obstetrics and Gynecology, Duke University Health System, Durham, North Carolina – sequence: 3 givenname: Nicole P. surname: Kerner fullname: Kerner, Nicole P. organization: Division of Women and Community Population Health, Department of Obstetrics and Gynecology, Duke University Health System, Durham, North Carolina – sequence: 4 givenname: Eleanor H. J. surname: Rhee fullname: Rhee, Eleanor H. J. organization: Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Duke University Health System, Durham, North Carolina – sequence: 5 givenname: Jeffrey A. surname: Kuller fullname: Kuller, Jeffrey A. organization: Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Duke University Health System, Durham, North Carolina – sequence: 6 givenname: Sarahn M. orcidid: 0000-0001-8384-3721 surname: Wheeler fullname: Wheeler, Sarahn M. organization: Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Duke University Health System, Durham, North Carolina |
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| Cites_doi | 10.1007/s00270-005-0167-0 10.1016/S0009-9260(05)80139-4 10.1097/AOG.0000000000001768 10.1097/OGX.0000000000000909 10.1016/S0002-9378(99)70429-1 10.7205/MILMED-D-15-00042 10.1002/jcu.1870200210 |
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2023 The Author(s). |
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| References_xml | – volume: 29 start-page: 401 issue: 03 year: 2006 ident: ref6 article-title: Transvaginal aspiration of ovarian cysts: long-term follow-up publication-title: Cardiovasc Intervent Radiol doi: 10.1007/s00270-005-0167-0 contributor: fullname: D Duke – volume: 41 start-page: 105 issue: 02 year: 1990 ident: ref3 article-title: Ultrasound guided fine needle aspiration of ovarian cysts: diagnosis and treatment in pregnant and non-pregnant women publication-title: Clin Radiol doi: 10.1016/S0009-9260(05)80139-4 contributor: fullname: K T Khaw – volume: 128 start-page: e210 issue: 05 year: 2016 ident: ref7 article-title: Practice Bulletin No. 174: evaluation and management of adnexal masses publication-title: Obstet Gynecol doi: 10.1097/AOG.0000000000001768 contributor: fullname: American College of Obstetricians and Gynecologists' Committee on Practice Bulletins—Gynecology – volume: 76 start-page: 437 issue: 07 year: 2021 ident: ref1 article-title: Adnexal masses in pregnancy publication-title: Obstet Gynecol Surv doi: 10.1097/OGX.0000000000000909 contributor: fullname: M K Montes de Oca – volume: 181 start-page: 19 issue: 01 year: 1999 ident: ref2 article-title: Adnexal masses in pregnancy: a review of 130 cases undergoing surgical management publication-title: Am J Obstet Gynecol doi: 10.1016/S0002-9378(99)70429-1 contributor: fullname: M P Whitecar – volume: 180 start-page: e1118 issue: 10 year: 2015 ident: ref5 article-title: Percutaneous drainage of a rapidly enlarging simple ovarian cyst in the third trimester publication-title: Mil Med doi: 10.7205/MILMED-D-15-00042 contributor: fullname: L C Bannon – volume: 20 start-page: 135 issue: 02 year: 1992 ident: ref4 article-title: Transvaginal aspiration of an ovarian tumor with a benign ultrasound appearance during the second trimester of pregnancy publication-title: J Clin Ultrasound doi: 10.1002/jcu.1870200210 contributor: fullname: D J Lee |
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| SubjectTerms | adnexal Case Report culdocentesis cyst ovarian pregnancy transvaginal |
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| Title | Transvaginal Ovarian Cyst Drainage in Third Trimester to Facilitate Vaginal Delivery |
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