Ovarian Cyst & Early Pregnancy: Understanding Risks & Next Steps

Question
Hello

My husband and I were trying for our second child when I discovered this Cyst. Had an ultrasound one month ago and it was 6 cm. DR says she wants me back on Oct 15 to have another ultrasound and check on the baby. She wants to wait it out to see if it shrinks. She would not discuss what surgical procedure that would need to happen if the cyst does not shrink. Can you tell me anything about this and how dangerous could this be. Could I be at risk for miscarriage due to the cyst. How dangerous is surgery for a pregnant woman? Dr says if cyst does not shrink we would need to remove it in second trimester. What would you advise? I'm scared :(

Answer
Dear Nicole,

Ovarian cysts are fairly common during pregnancy (about 1 in 1,000 pregnant women). In fact, in the U.S. ovarian cysts are found on trans-vaginal sonograms in nearly all premenopausal women and in up to 14.8% of postmenopausal women. Most of these cysts are functional in nature and benign. Most ovarian masses found during pregnancy are also benign; the incidence of ovarian cancer is only 1 in 25,000 births. Ultrasound can be helpful in determining if a mass is benign or malignant, but it cannot do so with 100% certainty. If ultrasound shows that the mass is strictly fluid-filled, without septation or thick walls, it is probably benign.

Benign cysts can cause pain and discomfort related to pressure on adjacent structures, torsion, rupture, hemorrhage (both within and outside of the cyst), and abnormal uterine bleeding. This is why your doctor wants to keep an eye on this cyst. Most benign cysts do resolve on their own, but persistent cysts that grow larger than 5-10 cm or those that are symptomatic or have features suggestive of malignancy may be removed surgically, preferably in the 2nd trimester. The 2nd trimester period is typically the safest time for any surgical procedure during a pregnancy. And many pregnant women have had to undergo emergency or necessary medical procedures or surgeries and have gone on to have healthy babies. It is done more often than you would think.

Your doctor is being prudent in watching and monitoring this cyst to make sure it resolves on its own. Try to relax - although I know that is hard to do. Anything out of the ordinary seems devastating with pregnancy. But this really isn't all that uncommon.

I hope this has helped you and answered your question. I wish you well.

Brenda