Postnatal outcome of antenatally diagnosed intra-abdominal cysts

Abstract

Objectives: To assess the postnatal outcomes following prenatal ultrasound diagnosis of fetal abdominal cyst at our institution. Methods: We identified all fetal abdominal cysts diagnosed between 2005 and 2016 using our ultrasound database. The fetuses were monitored during the pregnancy to assess their antenatal course. Follow-up was continued during childhood to determine the postnatal diagnosis and outcome. Results: We found 80 cases of abdominal cysts. The antenatal diagnosis was thought to be of ovarian origin (n=45, 56%); intestinal origin (n=15, 18%); choledocal cysts (n=3, 4%), liver cysts (n=2, 3%) and renal/adrenal cysts (n=2, 3%). In 16% of cases the antenatal diagnosis was not obvious. Of presumed ovarian cysts, postnatal follow-up was available in 91% of cases and ovarian cyst was confirmed in 98% of cases. Of these, 68% resolved spontaneously; 7% required fetal intervention; 15% required surgery after birth; and the remaining 10% were managed conservatively. One suspected ovarian cyst was postnatally diagnosed as a mesenteric cyst. Of presumed intestinal cysts, postnatal follow-up was available in 73%. Of these 64% resolved spontaneously. The postnatal diagnosis was confirmed in 75%: enteric duplication cyst (50%) and mesenteric cyst (25%). Surgery was required in 1 out of 2 of duplication cysts that persisted postnatally. In one case the postnatal diagnosis was revised to bowel dilatation. Conclusions: Postnatal follow up of abdominal cysts is important in determining the outcome and allowing appropriate counselling. In our series, the antenatal detection of ovarian cysts was high and the outcome good, with 75% resolving and only 15% ultimately requiring surgery. Cysts with intestinal origin are more difficult to determine antenatally, although two thirds resolve spontaneously. EP12.35 Reliability of prenatal diagnosis on neonatal outcome in isolated left-sided congenital diaphragmatic hernia: the results of the perinatal centre in the years Objectives: Mortality in CDH patients remains high despite the introduction of new prenatal and postnatal diagnostic and therapeutic modalities. In isolated CDH survival chances can be predicted by antenatal measurement of lung size and liver herniation. Accurate prenatal diagnosis is essential for prognosis and potential treatment in utero. The aim was to evaluate the prenatal ultrasound findings in assessing survival rate and the respiratory prognosis in fetuses with isolated left-sided CDH. Methods: Neonatal mortality and morbidity was recorded in 59 cases of left-sided isolated CDH diagnosed prenatally in tertiary perinatal centre. Retrospective and regression analysis was used to identified significant predictors. Results: Survival rate in the study group was 73% (43/59). We found no statistically significant relationship between survival and the presence of polyhydramnios, gestational age at diagnosis, gestational age at birth and birth weight and also lung-to-head ratio (LHR) and observed/expected LHR (O/E LHR) values. Intrathoracic liver herniation was...

Fetal intra-abdominal kistlerin prenatal tanı ve perinatal sonuçları

“…Accordingly, Özyüncü et al reported overall spontaneous mortality rate to be 11/64 (17%). Intrauterine deaths in our series were 2/17 (11.8%), while this was found to be 3.6% and 4.2% in previous reports, respectively (1,21). We think this difference arises from the inclusion criteria of the study groups.…”

“…Fetal abdominal cysts (FAC) can originate from renal, intestinal, mesenteric, ovarian, hepatic, and biliary systems (1). In the differential diagnosis, it is difficult to define the precise etiology of FAC prenatally.…”

Perinatal Outcomes of Fetal Abdominal Cysts and Comparison of Prenatal and Postnatal Diagnoses

“…The mean gestational age of liveborn cases was 37.4 weeks ( 8 2.27) and the mean birth weight was 2,907.2 g ( 8 554.71). Surgery was (1) ileal atresia (1) intestinal obstruction (4) ileal atresia (2) intestinal atresia (1) urogenital sinus abnormality (1) jejunal atresia (2) jejunal atresia (2) Mesenteric (2) mesenteric (2) mesenteric (1) normal (1) Ovarian (14) ovarian cyst (14) ovarian cyst (8) mesenteric cyst (2) normal (4) Genitourinary (21) double collecting system (1) double collecting system (1) megacystis-PUV (13) megacystis-PUV (8) renal cystic dysplasia (1) urogenital sinus abnormality (2) normal (2) pelviectasis (1) pelviectasis (1) renal cyst (5) megaureter (1) ( table 1 ), 36 had uniloculated, 13 biloculated, 2 solid, and 20 multiloculated complex appearance. Among the uniloculated simple cystic lesions, the most common localization was in the right (17) and upper (11) quadrants.…”

“…In spite of the advancing imaging technologies, the detection rates of ultrasonography in the identification of the origin of fetal abdominal cysts are still far below expectations. Therefore, the diagnosis is reported to be imprecise, and prediction of neonatal intervention is poor [4,9] , both of which complicate the counseling and management of the case [3] . The positive predictive value of ultrasonography in the identification of the cysts' origin on a system basis in our series approached 75%, meaning that one-fourth of the cysts diagnosed as intra-abdominal cysts antenatally actually involved other systems.…”

“…Other than renal causes and bowel dilatations, common etiologies for abdominal cysts are ovarian cysts, enteric duplication cysts, hepatic and biliary cysts, meconium pseudocysts, and mesenteric cysts [3,4] . Although it is rather easy to detect an obvious fetal abdominal cyst with ultrasonography, it may sometimes be problematic to identify the true origin [5][6][7][8] .…”