Ovarian cyst in pregnancy

Causes of ovarian cysts in pregnancy

Pregnancy is a hormonal exception for women. In principle, however, ovarian cysts can also occur during pregnancy without this having to be the direct cause of the cysts.

However, hormonal changes during pregnancy can also be the direct cause of the development of certain ovarian cysts. One cyst that occurs almost exclusively during pregnancy is the Corpus luteum cyst. This cyst is also known as a yellow body cyst.

The corpus luteum is formed after ovulation and mainly produces estrogen. He is considered to be in the first three months of pregnancy Corpus luteum graviditatis responsible for the production of progesterone and the maintenance of pregnancy.

If the egg is not fertilized, it will regress after menstruation. During pregnancy, the corpus luteum can grow cystically and reach a size of up to 8 cm. However, it regresses without consequences.

Furthermore, in the context of multiple pregnancies, so-called Lutein cysts arise.

The far more common cause, however, is an artificial triggering of ovulation through hormonal pre-treatment. Lutein cysts form when the concentration of the pregnancy hormone HCG is greatly increased. The cysts can grow up to 20 cm. They regress after the end of the hormone supply, i.e. after birth, and do not have to be surgically removed.

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Diagnosing ovarian cysts in pregnancy

Ovarian cysts during pregnancy are mainly detected and diagnosed by the ultrasound examination.

Both vaginal and abdominal (over the abdomen) ultrasound examination can make ovarian cysts visible and thus allow an assessment of the type of cyst. Cysts differ from malignant tumors in their appearance on ultrasound. They are smoothly bordered and have a regular structure.

Furthermore, one speaks of an anechoic content that appears evenly black in the ultrasound. Experienced gynecologists can also distinguish the type of cyst based on its appearance.

Read more on the topic: Cyst on the ovary

Concomitant symptoms of ovarian cysts in pregnancy

Functional ovarian cysts that appear during pregnancy usually do not cause symptoms.

They are symptom-free and can only be determined by the ultrasound examination.

In some cases, however, they can also lead to discomfort during pregnancy. As they grow, very large ovarian cysts can press on neighboring organs and thus lead to abdominal pain and colicky pain.

Back pain can also occur. Increased pressure on the bladder can lead to an increased urge to urinate. Pressure on the intestines can lead to constipation.

Ovarian cysts can rarely lead to complications that require immediate medical attention. One possible complication is the twisting of the stem of a pedicled cyst. This causes sudden onset of severe colic, nausea and vomiting. A ruptured ovarian cyst leads to blood and fluid loss in the abdomen and can cause life-threatening shock.

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Ovarian cyst pain during pregnancy

Ovarian cysts during pregnancy are usually symptom-free. They only lead to pain in rare cases and when they grow heavily.

Pressure on neighboring organs can cause abdominal pain. Back pain is also possible. However, severe pain is rather uncommon and mostly indicates other causes.

Pedunculated cysts can rarely rotate on their own axis. This is known as stem rotation. In this case, the most severe colic occurs suddenly. The stem rotation must be treated surgically immediately.

Treatment of ovarian cysts during pregnancy

An ovarian cyst during pregnancy usually does not require treatment. Since it is a benign structure, there is no danger to the mother's life, unlike a tumor of the ovaries.

The common cysts of pregnancy, namely the corpus luteum cyst and the lutein cyst, regress by themselves and do not have to be specially treated. In the first three months of pregnancy, luteal cysts are even necessary to maintain the pregnancy because they produce the important pregnancy-maintaining hormone progesterone. A corpus luteum cyst must therefore never be removed in early pregnancy.

Lutein cysts also resolve on their own after birth and do not require any therapy. If functional cysts cause severe discomfort, they can be surgically removed during pregnancy. However, surgery is usually only performed after the first half of pregnancy.

In early pregnancy, the risk of miscarriage from surgery is too great. Even after that, surgery should be carefully considered.

Drug treatment of the cysts during pregnancy is not necessary.

How long do ovarian cysts appear in pregnancy?

There are different types of functional ovarian cysts that can appear during pregnancy.

The most common cysts are luteal cysts. These usually resolve on their own after the first three months of pregnancy. However, they can rarely last longer. Lutein cysts also regress, but only after the HCG intake has ended, i.e. after birth.

Other ovarian cysts can persist throughout pregnancy and beyond. If the cysts then cause discomfort, surgical removal can be performed.

Is pregnancy possible despite an ovarian cyst?

Typically, ovarian cysts do not interfere with your ability to conceive.

Only the so-called Polycystic Ovarian Syndrome (PCO) is associated with infertility in women. It is characterized by a lack of menstrual bleeding, many cysts on the ovaries and so-called virilization symptoms. These include a male hair pattern and voice changes.

It is often associated with a metabolic syndrome, which is characterized by obesity, increased blood lipid and blood sugar levels.

On the ultrasound scan, you can see a lot of cysts on both ovaries. Furthermore, the blood test shows increased testosterone levels and decreased progesterone levels.

If they want to have children, the affected women are treated with the drug clomiphene, which stimulates the follicles and causes ovulation.

Read more on the topic: Symptoms of Polycystic Ovarian Syndrome

Can an ovarian cyst be a sign of pregnancy?

An ovarian cyst is not a sign of pregnancy in the strict sense. Although it can occur as part of the hormonal changes in pregnancy, it must not be interpreted as a sign of pregnancy.

Even corpus luteum cysts can develop without pregnancy and are therefore unsuitable as signs of pregnancy.