Ultrasonographic criteria for the conservative management of antenatally diagnosed fetal ovarian cysts.

Routine antenatal ultrasonography at regular intervals will detect fetal ovarian cysts. Before the era of ultrasound, the attending physician was unaware of the presence of these cysts. It is therefore imperative that a protocol for the management of asymptomatic, antenatally diagnosed ovarian cysts be developed. The vast majority of these cysts are benign and functional; laparotomy during the neonatal period is not only unnecessary but may be harmful. In a prospective study undertaken at Tygerberg Hospital, Parowvallei, South Africa, six ultrasound criteria were drawn up for the safe, conservative management of these neonates. Adherence to these criteria enabled us to manage five of seven neonates conservatively. Laparotomy in one neonate showed a benign functional ovarian cyst. Retrospectively, this case should have been managed conservatively. In the remaining neonate a laparotomy for an acute abdomen demonstrated torsion of an ovarian cyst, emphasizing the necessity for adequate follow-up.