Neonatal ovarian cysts. Diagnostic and therapeutic management [Neonatale ovarialzysten. Diagnostisches und therapeutisches management]

The detection rate of neonatal ovarian cysts has markedly increased with the widespread use of ultrasonography during pregnancy. Up to now the decision for an invasive therapy has depended primarily on the size of the cyst. Recent insights into the spontaneous postnatal course of ovarian cysts within the 1st year of life have made it possible to prefer a less invasive procedure or at least to postpone any invasive treatment beyond the neonatal period. Having studied the literature published to date, we recommend the following approach: (1) When ovarian cysts are so large that they distend the fetal abdomen to the extent of dystocia of labor primary cesarian section or prenatal aspiration in utero shortly before the time of birth should be performed. (2) All ovarian cysts that are symptomatic in the neonatal period require immediate surgical intervention, preferably by laparoscopy. (3) In the case of ovarian cysts that are asymptomatic in the neonatal period the approach needs to be more tailored to the individual case. (a) Asymptomatic simple cysts with a diameter of more than 5 cm and with no tendency to regress spontaneously should be operated on within the neonatal period, preferably by laparoscopy. (b) In the case of any other asymptomatic neonatal ovarian cyst a wait-and-see policy with ultrasound monitoring can be adopted and continued at least until the end of the neonatal period. © 2007 Springer Medizin Verlag.