Prof. Dr. Orhan Ünal emphasized that those who are considering pregnancy should be examined beforehand and have their ovaries, uterus and cervix checked, and said that the presence of a disease that will prevent treatment during pregnancy should also be investigated.
Ovarian cysts consist of fluid-filled sacs or vesicles seen inside the ovary. However, the fluid can be in the form of abscess, blood, cancer cell content or clear liquid content, and the risk and importance of the cyst changes according to the content of the cyst. Stating that with the widespread use of ultrasonography for pregnancy follow-up and anomaly screening in the baby, the rate of detecting cysts in the ovary during pregnancy has increased. Dr. Orhan Ünal, the first 16-18 weeks of pregnancy. He reminded that 90 percent of non-complex ovarian masses below 6 cm detected in the 2nd week of pregnancy are functional, that is, natural cysts.
It can occur at any age
Age is not a factor in the emergence of ovarian cysts. Normal or physiological follicle cysts, which cannot crack in girls with ovulation problems in young people, can grow every month and reach 5-10 cm, and can be seen in small 0.5-1 cm series, which we call polycystic ovaries, in large numbers. cysts may occur. prof. Dr. Orhan Ünal underlined that cysts seen only in reproductive age and after menopause should be evaluated, followed by ultrasound and even imaging methods such as MRI or tomography should be performed. However, detailed examinations such as evaluation of tumor markers (CA 125) in the blood may be required.
Ovarian cysts usually progress insidiously and are a symptom unless they show excessive growth and put pressure on organs in the abdomen such as the bladder or intestines. does not give. For this reason, a malignant ovarian cyst can only be detected at an advanced stage in a woman who does not have annual check-ups. Stating that this situation brought the treatment to a difficult point, Prof. Dr. Orhan Ünal continued his words as follows:
“The biggest risk of the growth of ovarian cysts is that they turn from the stem due to the size and weight of the cyst – which we call the torsion of the cyst – the nutrition is disrupted and the ovarian tissue is damaged. In this case, there is a risk of losing one of the ovaries, especially in women who desire pregnancy at a young age. In this emergency, which causes symptoms similar to appendicitis perforation, the patient has to apply to the emergency clinic with extreme abdominal pain and a hardened abdomen. If left untreated, it is vital.
Attention to hormonal cysts
Pointing out that ovarian cysts do not prevent pregnancy as long as they do not cover both ovaries and reduce the existing ovarian reserve, Prof. Dr. Orhan Ünal said:
“In some cases, pregnancy can be seen in bilateral cysts. Because the tissues other than the ovarian cyst are normal, the ovary continues to function, and the ovulation, which we call monthly cracking, may continue. However, in cysts that occur due to hormonal interaction, such as polycystic ovarian syndrome and chocolate cysts caused by endometriosis, ovulation cannot occur and the function of conception may be prevented when there are cysts, since hormone production or functioning of the ovary is mostly impaired.
For this reason, those who are considering pregnancy should be examined beforehand, have their ovaries, uterus and cervix checked, and investigate the presence of a disease that will prevent treatment during pregnancy. prof. Dr. Orhan Ünal gave the following information on what to do apart from this: “If a regular smear is not taken or not checked at all, vaginal smears should be taken, and ovaries and uterus should be examined with ultrasound. If there is an abnormal condition according to the results obtained in the imaging, it should be evaluated. “It is important for them to have their treatment done if they cause an obstacle to pregnancy or the continuation of the pregnancy. It is also important to perform routine pre-pregnancy blood count, blood sugar, urinalysis, rubella, thyroid examination and tests, and if they have existing complaints, it is important to carry out tests for them.”
If there is an ovarian cyst during pregnancy
In general, the majority of cysts occurring during pregnancy are benign and Prof. Dr. Orhan Ünal, said that it regresses spontaneously in the following weeks of pregnancy, “Most of the benign or malignant ovarian cysts detected during pregnancy are unilateral. Cysts that do not regress after 16-18 weeks have a higher risk of growth. Persistent large cysts can cause complications from torsion, rupture, bleeding, or difficult delivery. Therefore, it is very important for the physician following such cysts to schedule the operation without complications. The probability of these cysts getting worse is around 1-8 percent.”
Stating that severe pain can occur due to ovarian cyst torsion, that is, the rotation of the cyst from its stem, Prof. Dr. Orhan Ünal, “The stress factor caused by pain may trigger premature birth or miscarriage. At the same time, the threat of miscarriage or premature birth pain may begin due to the size of the ovarian cyst or complications that may occur in the cyst. However, some negative effects may occur if the baby is born prematurely with an indirect effect by causing premature birth or miscarriage.” said
How to follow up cysts during pregnancy
Follow-up of endometriosis or chocolate cysts in other cysts during pregnancy Prof. Dr. Orhan Ünal said that there is no difference in terms of follow-up and treatment:
“The value of ‘CA 125’, which we call a tumor marker that is high in malignant cysts, is also high in these cysts. out and cause anxiety. Requesting a tumor marker called ‘HE 4’, which is not thought to be affected by pregnancy, is important in terms of evaluating the possibility of endometriosis and cancer, which are seen very rarely. In polycystic ovary, it may only require treatment for conception. When seen together with pregnancy, no special follow-up is required and it is sufficient to continue with normal pregnancy follow-up.