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Nineteen newborns with prenatal diagnosis of ovarian cysts were referred to our institution during a 6-year period. Only those cysts more than 5-cm in diameter were included. Nine cases presented simple cysts and 7 of them underwent needle aspiration, 5 under ultrasound guidance and 2 with laparoscopic assistance. In one case an open surgical cystectomy was performed and the other had spontaneous resolution. No oophorectomies were performed in this group. Ten patients had complicated ultrasound pattern (septa, fluid/debris, calcification). From this group, 8 patients had ovarian torsion and 6 underwent laparoscopic oophorectomy (one bilateral). Open surgical oophorectomy was performed in 2 patients early in the series. Two cases were misdiagnosed. In one case a simple cyst appeared as complicated because of associated meconium peritonitis with calcifications. The other case underwent an initial laparoscopy that unveiled an intestinal duplication that was excised under open surgery. Mean operative time for laparoscopic approach was of 40 minutes and all patients left the hospital within 24 hours. We conclude that it is possible to preserve the neonatal ovary in noncomplicated cysts. Both laparoscopic and ultrasound-guided needle aspiration are safe and minimally invasive procedures for simple cyst-definitive treatment. Initial laparoscopic approach is the procedure of choice for complicated cysts thus providing diagnostic and treatment capabilities.

Dysraphism is a defect in neural tube development, leading to dysplastic growth of the spinal cord and meninges. Myelomeningocele (MM) is just one of its forms. Hydrocephalus is among the most important alterations in MM and occurs as a consequence of Arnold-Chiari malformation (AC). Experimental models have been developed in sheep, rabbits and rats to study MM physiopathology, allowing a more detailed evaluation of clinical parameters involved in this anomaly. Objective: Using the experimental model of dysraphism in fetal rats, the aim of this study was to evaluate the relevance of AC malformations, clinical parameters and grade of histological lesions. Materials and Methods: Three groups with 16 fetuses in each were compared, MM, Control and Sham, after intrauterine surgical creation of MM on day 18.5 of gestation (term = 22 days). AC was evaluated by photographic comparison of sagittal cuts of fetal heads. Clinical and histological evaluations were also made. Results: 88% of AC (14/16) in MM fetuses were obtained, besides 100% of clinical alterations. Necrosis and erosion of the spinal cord exposed to amniotic fluid were verified in histology. Conclusion: The presence of AC in the dysraphism rat model was high. These results allowed the use of this model to study alterations and intrauterine evolution of MM in a fashion similar to those observed in humans.

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