Hala Mohamed Shalaby
Riyadh Care Hospital, Saudi Arabia
Hala Shalaby has completed her Medical College from Zagazig University in Egypt (1989), then got DCH from the same university in 1996 and finally passed MRCPCH and became Member of The Royal College of Pediatric and Childhood in London/England since 2015. She is a Senior Registrar of Pediatric and Neonates in Riyadh Care Hospital in Riyadh, Saudi Arabia and has been working there for 15 years. She has published in the last year’s conference proceedings of 5th International Conference on Pediatric Nursing & Health in Cologne Germany and presented many lectures in Saudi Arabia.
Objectives: Discuss the etiology, diagnosis and management of ovarian cysts in neonates with spotlight on alarming symptoms and signs after birth.
Background: Ovarian cysts are the most frequent, prenatally diagnosed intra-abdominal cysts in particular with ultrasonography. The management of fetal ovarian cysts is still controversial.
Etiology: It can happen due to excessive maternal hormone stimulation from HCG. The secretion of FSH from the fetal pituitary, beginning at 20 weeks of gestation may increase the number and size of the follicles. It can also result due to pathological disorders in the mechanism of folliculogenesis. It happens when after birth E2 and HCG decrease rapidly while, FSH declines more slowly. The association of fetal ovarian cysts with maternal diabetes or fetal hypothyroidism has been described.
Incidence: It has been estimated at more than 30% based on investigation of still born or infants who died within 28 days after birth.
Diagnosis: Through serial abdominal ultrasound scans. Antenatal diagnosis is possible especially with the third trimester and it is usually unilateral.
Complications: The complications associated include ovarian torsion, compression of other viscera and possible intestinal obstruction. Rupture with hemorrhage of large sized cyst and signs of Polyhydraminos.
Management: It depends according to its size and the complications associated with it such as; torsion for example or viscera compression. Usually, the management is surgical as; simple cystectomy in case of unilateral cyst or oophorectomy and cystectomy if bilateral cysts exists.
Case presentation: A term female baby was delivered in our hospital RCH on November 2015 and developed abdominal distension with palpable mass followed by respiratory distress and irritability. She was diagnosed to have unilateral ovarian cyst & was operated successfully.