Many individuals experience concern when an ovarian cyst is discovered during pregnancy. However, most ovarian cysts found during gestation are benign, do not pose a threat, and frequently resolve on their own.
Common Ovarian Cysts in Pregnancy
An ovarian cyst is a fluid-filled sac on an ovary, common in women of childbearing age and often a normal part of the menstrual cycle. During pregnancy, the most common types are functional cysts, including follicular and corpus luteum cysts.
Follicular cysts develop when a follicle (the sac containing an egg) does not rupture to release the egg during ovulation and continues to grow. Corpus luteum cysts form after an egg is released; the follicle transforms into the corpus luteum, producing progesterone essential for supporting early pregnancy.
If the corpus luteum fills with fluid and does not regress, it forms a corpus luteum cyst. These cysts are a normal and beneficial part of early pregnancy, producing progesterone until the placenta takes over around 10 weeks. Functional cysts generally resolve spontaneously by the second trimester.
Do Cysts Cause Miscarriage?
The vast majority of ovarian cysts do not cause miscarriage. Most are harmless, resolve without intervention, and pose no risk. Common functional cysts, like corpus luteum cysts, are normal findings that support pregnancy.
In very rare instances, a cyst might indirectly contribute to complications that could put a pregnancy at risk. One such complication is ovarian torsion, where the ovary twists on its supporting tissues, cutting off blood supply. If untreated, it may lead to ovarian tissue damage and, in some cases, has been associated with miscarriage. Pregnancy itself increases torsion risk due to hormonal changes and ovarian enlargement.
Another rare scenario involves a cyst rupturing, which can lead to internal bleeding. While often manageable with pain relief, significant internal bleeding could potentially affect the pregnancy.
Conditions like Polycystic Ovary Syndrome (PCOS) or severe endometriosis may independently increase pregnancy complications, including a slightly elevated risk of miscarriage. This is due to the underlying condition itself rather than the cysts directly.
Symptoms That Warrant Concern
While most ovarian cysts are asymptomatic, certain symptoms indicate a potential complication requiring medical attention. Severe, sudden abdominal pain, often localized to one side, is a primary warning sign. This pain can be sharp and intense, and it may be accompanied by cramping.
Additional symptoms prompting immediate medical evaluation include persistent nausea and vomiting, fever, dizziness, or faintness. Vaginal bleeding or spotting, unrelated to normal pregnancy spotting, can also be a symptom of a ruptured cyst.
These symptoms suggest complications like ovarian torsion or a ruptured cyst with significant internal bleeding. Prompt diagnosis and intervention are important. Seek medical advice for any new or worsening abdominal pain during pregnancy.
Monitoring and Treatment of Cysts During Pregnancy
Ovarian cysts are typically monitored using ultrasound, a safe and effective imaging method. Most benign cysts resolve by the second trimester, so a watchful waiting approach is adopted. Regular follow-up ultrasounds track the cyst’s size and characteristics.
Intervention may be considered if a cyst causes persistent or severe pain, rapid growth, or suspicious features. Complications like ovarian torsion or significant rupture necessitate treatment. Treatment options vary, including pain management.
Surgical removal of a cyst during pregnancy is generally reserved for complications or suspected malignancy. If necessary, surgery is often performed during the second trimester (typically 16-20 weeks), when risks are lower. Minimally invasive laparoscopic surgery is often preferred. If a corpus luteum cyst is removed early (before 10 weeks), progesterone may be administered to support the pregnancy.