Objectives: The aim of the present study was to evaluate the outcome of fetal ovarian cysts in relation to their ultrasonic appearance and size.
Methods: Forty-two fetal ovarian cysts were diagnosed in 41 fetuses and followed with serial ultrasonograms in utero and after birth until spontaneous or surgical resolution.
Results: Twelve fetal ovarian cysts that were echogenic at diagnosis and six that were anechoic at diagnosis but became echogenic at subsequent prenatal sonograms were all submitted to postnatal surgery. Of the remaining 24 cysts, all anechoic, four were successfully aspirated in utero, 11 resolved spontaneously after birth, and nine underwent postnatal surgery for complication. The outcome of cysts that were anechoic at diagnosis was significantly correlated with size (P = 0.01).
Conclusions: Echogenic fetal ovarian cysts should be always surgically removed. The outcome of anechoic cysts depends on the size at diagnosis, and serial ultrasonographic assessment is recommended; although not randomized, the present series suggests that in utero aspiration of cysts > 5 cm may prevent complication and subsequent oophorectomy.