Surgical aspects of the treatment of neonatal ovarian cysts in girls


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Abstract

Introduction. Neonatal ovarian cysts develop in case of hormonal imbalance in the mother-placenta-fetus system. Cystic transformation in the ovary may cause appendage torsion which leads to follicular necrosis and loss of ovarian reserve. Most often, torsion occurs in the utero, but in premature girls- due to the specific hormonal status - the risk of cyst growth and its torsion remains in the postnatal period. Currently, a unified approach to the surgical treatment of neonatal ovarian cysts is absent.

Material and methods. In the department of pediatric surgery for malformations in the Perinatal Center of the Amazov National Medical Research Center, 34 girls with ovarian cysts were examined during 2012-2020; 9 of them (27%) were premature. In the presented observation, we faced an ovarian cyst in the fetus of 30 week gestation.

Results. The cyst looked uncomplicated, but had the enormous size, so we discussed a possibility to perform an intrauterine puncture. However, due to severe hemolytic disease of the fetus and premature delivery, the intervention was not carried out. By the third week of life, torsion of the cystic-transformed ovary developed; necrosis and self-amputation of the right uterine appendage were revealed intraoperatively. By the age of three months, cystic transformation of the only ovary developed. Timely performed laparoscopic fenestration was organ-sparing. Further follow-up revealed preserved and normally growing single ovary what confirmed the right choice of surgical tactics.

Conclusion. Dynamic ultrasound examination of the pelvic organs is indicated to all premature girls, at least once every two weeks (in case of revealed ovarian cyst - weekly). We consider it reasonable to make the laparoscopic fenestration of uncomplicated cysts that have size of 3 cm and more. Newborn girls with ovarian cysts should be under the joint control of pediatrician and pediatric gynecologist for developing an individual follow-up plan.

About the authors

D. A. Malysheva

Almazov National Medical Research Centre

Author for correspondence.
Email: darmalysheva@gmail.com
ORCID iD: 0000-0002-0738-9640

Darya A Malysheva, MD, pediatric surgeon of pediatric surgical department, Institute of Perinatology and Pediatrics

Saint-Petersburg, 197341

SPIN-code: 3367-8610,

AuthorID: 1103017

Russian Federation

A. A. Sukhotskaya

Almazov National Medical Research Centre

Email: fake@neicon.ru
ORCID iD: 0000-0002-8734-2227

Saint-Petersburg, 107341

SPIN-code: 6863-7436,

AuthorID: 647729

Russian Federation

V. G. Bairov

Almazov National Medical Research Centre

Email: fake@neicon.ru
ORCID iD: 0000-0002-8446-830X

Saint-Petersburg, 107341

SPIN-code: 6025-8991,

AuthorID: 623392

Russian Federation

I. M. Kagantsov

Almazov National Medical Research Centre

Email: fake@neicon.ru
ORCID iD: 0000-0002-3957-1615

Saint-Petersburg, 107341

SPIN-code: 7936-8722,

AuthorID: 333925

Russian Federation

N. A. Kokhreidze

Almazov National Medical Research Centre

Email: fake@neicon.ru
ORCID iD: 0000-0002-0265-9728

Saint-Petersburg, 107341

SPIN-code: 9382-2225,

AuthorID: 648349

Russian Federation

I. E. Zazerskaya

Almazov National Medical Research Centre

Email: fake@neicon.ru
ORCID iD: 0000-0003-4431-3917

Saint-Petersburg, 107341

SPIN-code: 5683-6741,

 AuthorID: 323994

Russian Federation

F. A. Ovsyannikov

Almazov National Medical Research Centre

Email: fake@neicon.ru
ORCID iD: 0000-0002-3176-8958

Saint-Petersburg, 107341

SPIN-code: 2511-2772,

AuthorID: 597895

Russian Federation

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