QuestionI have been having severe pelvic pain and my doctor sent me for an ultrasound. I have a history of PCOS, some cysts getting quite large in the past, one requiring laparascopic surgery. My doctor also did blood work and determined that I am pregnant, he thinks only about 3-4 weeks. He saw a fetal sac in my uterus, but I also have an 8cm simple cyst on my right ovary. My Hcg levels have been doubling every 48 hours, but my cyst is not shrinking and I am still in a whole lot of pain. He has me taking percocet for the pain, but I am afraid this will affect the baby. What are my chances of pregnancy complications due to this cyst? They have not seen a heartbeat yet either, but he tells me it is too soon for this. I am terrified, we have been trying to have a baby for almost 2 years and I just want someone to tell me what I am really facing here. Is there any other tests I should be asking my doctor to order? Thanks so much for your help.
AnswerDear Rebecca,
OK, first, it is too early for heart activity to be seen via ultrasound if you are just 3-4 weeks along. So you really do not need to be worried about that. A visible heartbeat can often be seen and detected by ultrasound at about 6 weeks and is usually clearly detectable by 7 weeks.
Drugs are classified into risk categories for women who are pregnant. There are five categories - A,B,C,D, and X (from least to highest risk). Percocet is a FDA Pregnancy Risk Category C drug. This means that there have been no adequate and well controlled studies done on pregnant women, but studies on animals show adverse effect and toxicity on fetus. Drugs in this category should be given only if the potential benefit outweighs the potential risk to the fetus. (It is left to the doctor's discretion)
Ovarian cysts are fairly common during pregnancy (about 1 in 1,000 pregnant women). In fact, in the US 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. 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 will want 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.
Try to relax - although I know that is hard to do. Anything out of the ordinary seems devastating with your first pregnancy. But this really isn't all that uncommon.
I hope this has helped you and answered your question. I wish you well.
Brenda
