Preterm Vaginal Delivery and Postpartum Laparotomy for a Giant Ovarian Serous Cyst: A Case Report

Abstract

Ovarian cysts during pregnancy can be functional, benign, or malignant neoplasms. Managing these cysts during pregnancy is a critical issue and depends on many different factors. Ovarian cyst size, type, origin, patient gestational age, and medical condition are the most important factors in choosing appropriate management. In this report, we will discuss the management of a giant ovarian serous cyst, an intriguing incidental finding on ultrasonography during the third trimester. In the current report, our hospital received a referral for a 26-year-old Gravida 4 Para 3 at 35 weeks of gestation who had a 4-month history of progressive generalized abdominal swelling, abdominal fullness, early satiety, and intermittent episodes of mild low back pain. Ultrasonography revealed a single live intrauterine foetus at 34 weeks with a separate, huge cystic mass (25 cm by 29 cm). Twelve hours after her admission, she experienced a spontaneous onset of labour, leading to a preterm normal vaginal delivery of a 2.5 kg female baby with an APGAR score of 8 in the first minute and 10 in the fifth minute. Two weeks later, during the puerperium, she developed progressive abdominal distension and worsening discomfort; she underwent a laparotomy and a left salpingo-oophorectomy to remove a large left ovarian mass weighing 13 kg. We sent the specimen for histopathology, and the results showed a benign ovarian serous cyst. The patient had uneventful progress in post operatively follow up and was discharged from an outpatient clinic in good condition after her puerperium period.