Follicular cyst of ovary
ICD-10 N83.0 · ICD-11 GA18.0

Management of Follicular Cyst of Ovary in a Female Fetus Diagnosed In Utero

This protocol addresses the perinatal approach to follicular cyst of ovary when a fetal ovarian cyst is identified prenatally in a female fetus — one of the most common abdominal cystic lesions encountered in the antenatal period.

Clinical Scenario
Fetal ovarian cysts are the most common abdominal cysts in female fetuses, typically identified during third-trimester ultrasound. When detected in utero, the primary concern is preventing potential complications arising from progressive cyst enlargement.
Management Approach
The approach centres on careful ultrasound surveillance to track cyst behaviour and avoid complications. Depending on cyst characteristics, active intervention may be considered as an alternative to expectant monitoring — with the clinical goal of achieving spontaneous resolution, particularly in simple cysts.
Full algorithm, criteria, and stepwise protocol available via the link below.
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References

DOI: 10.3390/healthcare13070775

Fetal ovarian cysts, as the most common abdominal cysts in female fetuses with a frequency of 1:2500, are usually diagnosed in the third trimester.

The highest priority in perinatal management is to carefully monitor the development of the cyst to avoid potential torsion and subsequent ovarian necrosis and other possible complications, such as cyst compression on other intra-abdominal organs.

While decompression of the cyst by percutaneous aspiration has been suggested on the one hand, particularly for cysts of ≥40 mm in diameter or for those with rapid growth, defined as ≥10 mm per week, on the other hand, a conservative expectant approach has been advocated, given the potential for spontaneous resolution, particularly in simple cysts.

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