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Outcome of fetal ovarian cysts diagnosed on prenatal ultrasound examination: systematic review and meta-analysis

Bascietto, F; Liberati, M; Marrone, L; Khalil, A; Pagani, G; Gustapane, S; Leombroni, M; Buca, D; Flacco, ME; Rizzo, G; et al. Bascietto, F; Liberati, M; Marrone, L; Khalil, A; Pagani, G; Gustapane, S; Leombroni, M; Buca, D; Flacco, ME; Rizzo, G; Acharya, G; Manzoli, L; D'Antonio, F (2017) Outcome of fetal ovarian cysts diagnosed on prenatal ultrasound examination: systematic review and meta-analysis. Ultrasound in Obstetrics & Gynecology, 50 (1). pp. 20-31. ISSN 1469-0705 https://doi.org/10.1002/uog.16002
SGUL Authors: Khalil, Asma

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Abstract

OBJECTIVES: To explore the outcome of fetuses with a prenatal diagnosis of fetal ovarian cysts. METHODS: Medline and Embase databases were searched. The following outcomes were explored: resolution of the cyst, change of ultrasound pattern, occurrence of ovarian torsion and intra-cystic haemorrhage, need for surgery, need for oophorectomy, detection rate of prenatal ultrasound in correctly identifying ovarian cysts, type of ovarian cyst at histopathological analysis and intra-uterine treatment. Meta-analyses using individual data random-effect logistic regression and meta-analyses of proportion were used to analyse the data. Quality assessment of the included studies was performed using the Newcastle-Ottawa Scale. RESULTS: Thirty-four studies (954 fetuses) were included. 54.6% (95% CI 47.0-62.0) of the cysts regressed either during pregnancy or after birth. The likelihood of resolution was significantly lower in complex vs simple cysts (OR: 0.15, 95% CI 0.10-0.23) and in those ≥ 40 compared to < 40 mm (OR: 0.03, 95% CI 0.01-0.06). Change in ultrasound pattern was associated with an increased risk of ovarian loss (PP: 57.7%, 95% CI 42.9-71.8). The risk of ovarian torsion was significantly higher in cysts ≥ compared to those < 40 mm (OR: 30.8, 95% CI 8.6-110). The risk of having surgery was higher in patients with cysts ≥ compared to <40 mm (OR: 64.4, 95% CI 23.6-175) and in complex cysts compared to simple cysts, irrespective of the cyst size. In cases undergoing prenatal aspiration of the cyst, the rate of recurrence was 37.9% (95% CI 14.8-64.3), while torsion and haemorrhage were diagnosed after birth in 10.8% (95% CI 4.4-19.7) and 9.7% (95% CI 3.7-18.3) of the cases treated. Finally, 17.7% (95% CI 9.3-,28) of fetuses undergoing fetal therapy had surgery after birth. CONCLUSION: Cysts size and appearance are the major determinants of perinatal outcome in these anomalies.

Item Type: Article
Additional Information: This is the peer reviewed version of the following article: Bascietto, F., Liberati, M., Marrone, L., Khalil, A., Pagani, G., Gustapane, S., Leombroni, M., Buca, D., Flacco, M. E., Rizzo, G., Acharya, G., Manzoli, L. and D'Antonio, F. (2017), Outcome of fetal ovarian cysts diagnosed on prenatal ultrasound examination: systematic review and meta-analysis. Ultrasound Obstet Gynecol, 50: 20–31., which has been published in final form at http://dx.doi.org/10.1002/uog.16002. This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Self-Archiving.
Keywords: Outcome, Ovarian cysts, Ultrasound, Obstetrics & Reproductive Medicine, 1114 Paediatrics And Reproductive Medicine
SGUL Research Institute / Research Centre: Academic Structure > Molecular and Clinical Sciences Research Institute (MCS)
Journal or Publication Title: Ultrasound in Obstetrics & Gynecology
ISSN: 1469-0705
Language: ENG
Dates:
DateEvent
6 July 2017Published
21 June 2016Published Online
10 June 2016Accepted
Publisher License: Publisher's own licence
PubMed ID: 27325566
Go to PubMed abstract
URI: http://openaccess.sgul.ac.uk/id/eprint/108173
Publisher's version: https://doi.org/10.1002/uog.16002

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