Removing Ovarian Cyst During Pregnancy: Why This Surgery Needs To Be Done

Ovarian cysts can complicate pregnancies unless they are removed surgically.

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It is not uncommon for an expecting mum to get diagnosed with an ovarian cyst. These are noncancerous masses that grow on top of the ovaries. They usually come and go naturally, disappearing within a few months without you ever noticing. In fact, removing ovarian cyst during pregnancy is also not unusual.
 
But these can be troublesome when they overstay their welcome. And turns out most pregnant mothers in Singapore also worry about this.
 
A pregnant mum recently posted a similar concern on theAsianparent community platform. She found out about her “8cm ovarian cyst” during her first gynaecologist appointment. Feeling helpless, she asked for suggestions from fellow mums on how to deal with the situation.

Ovarian Cyst During Pregnancy: Is It Normal, Mummies?

Screengrab: theAsianparent community


She wrote, “Hi all, we found out that we were pregnant a week ago and went for our first check-up yesterday but our gynae found an 8cm ovarian cyst. Did anyone happen to be in such a situation before?”
 
Thankfully for her, many Singaporean mums jumped in to help. They shared their personal experiences with removing ovarian cyst during pregnancy and suggested some tips to recoup as well. 

1. Ovarian cyst surgery can help solve this–even after a miscarriage

Screengrab: theAsianparent community


One SG mum responded to the post and shared her personal experience with ovarian cyst. She said that she found out about the “10 cm cyst” during her pregnancy and while it was to be removed, the doctors couldn’t because she had her miscarriage at 13 weeks.
She also shared her advice on what needs to be done before removing ovarian cyst during pregnancy. She wrote,

“Normally, they say, the surgery is safe, but you must find yourself a good doctor.”
After the miscarriage, she had to wait for two cycles of her period for the surgery to proceed. She underwent a keyhole surgery, which she felt was less painful than a cut surgery.
 

“Right after surgery, I got my rainbow baby currently at 13 weeks. The belly button still hurts sometimes. I don’t know how will it be when pregnancy is full-on. But dun worry too much, get yourself a good doctor,” the mum added. 

2. Cyst size can reduce post delivery 

Another mum shared that she went through her pregnancy with the ovarian cyst intact. 
 

“I have 1 ovarian cyst found during the checkup and it did become smaller throughout the pregnancy but was still there. Gynae reassured me that the cyst will not be causing any issues during my pregnancy.
After I gave birth, I went back for a check-up for the cyst. The cyst went from 6cm to 2cm but remain the same throughout the few months moving forward after giving birth,“ she wrote.

3. Best to consult with your doc!

Screengrab: theasianparent community

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Mum of three, ‘Adlina Chew’ wrote,

“I think your gynaecologist will be in the best position to advise you on the complications and treatments.”
User ‘Jasmin Tan’ also suggested the same. She said,

“Your gynae should be able to give you the best advice, take good care.”
If you are in a similar situation, fret not. Instead of letting it affect your health, follow the advice of your doctor. And if you are advised about removing an ovarian cyst during pregnancy, get all your facts right to make an informed decision. Fortunately for you, we’ve got the right information for you.

Ovarian Cyst And Its Risks During Pregnancy

Image courtesy: Pixabay

As stated before, ovarian cysts are noncancerous masses that grow on the ovaries. During your pregnancy, the corpus luteum produces hormones. These hormones nourish and support the uterine lining and the growing baby until the placenta takes over at around 10 to 12 weeks.

But, in some pregnancies, this corpus luteum fills with fluid and remains on the ovary instead of regressing. This is called a corpus luteum cyst.

Type of Ovarian Cysts

Functional cysts refer to the two most prevalent varieties of ovarian cysts, which include:

Follicular cysts

 When an ovarian follicle—the tiny sac where the egg develops—does not really release the egg as it should at the time of ovulation, it continues to grow and fill with fluid, leading to the formation of follicular cysts.

Corpus luteum cysts

 After an egg is released from a follicle after ovulation, a corpus luteum grows. The follicle sac contracts into hormone-producing cells that support the remainder of the menstrual cycle or, in the case of pregnancy, the developing foetus. However, a cyst develops if fluid builds up in the empty follicle and the sac does not contract.

Pathological cysts and ovarian cancer are two less frequent kinds of ovarian cysts.

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Dermoid cysts

These ovarian germ cell-based cysts, also known as teratomas, might contain teeth, hair, skin, or fat. They are there from birth but are frequently not realised until much later in life.

Endometrioma, or “chocolate cysts,”

It exists in women who have endometriosis. These cysts can seem deeper in colour because they are filled with endometriotic fluid or blood. They might cause pain.

Cystadenomas cysts

These may appear on the ovary’s surface. They frequently have substantial sizes.

While these are quite common, they can also cause complications during pregnancy, if they continue to grow. 

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There is a risk that cysts may rupture, twist or even cause problems during childbirth. All of these could lead to its fluids coming out creating a poisonous environment inside your womb. 

If you have polycystic ovary syndrome, you need to be more careful. You stand a risk of a miscarriage, gestational diabetes or even premature delivery.

Cyst Found In Ultrasound Pregnancy First Trimester

Image from iStock

Pregnancy frequently results in ovarian cysts. These cysts are often benign (not malignant) and unharmful. The majority of ovarian cysts are painless, benign, and disappear on their own.

Ovarian cysts don’t typically cause symptoms either, however, they can be unpleasant if they rupture.

During pregnancy, ovarian cysts that continue to grow have the potential to burst, twist, or interfere with labour. Additionally, you will require emergency surgery if a cyst causes the ovary to twist (a condition known as ovarian torsion).

Any ovarian cyst diagnosed while you are pregnant will be closely watched by your doctor. Doctors can safely remove an ovarian cyst during pregnancy, however, it’s typically not necessary.

Causes of Ovarian Cyst During Pregnancy

A corpus luteum cyst is the most typical form of ovarian cyst during pregnancy. The follicle that delivered the egg swells with fluid and stays on the ovary rather than contracting. By the middle of the second trimester, these cysts typically disappear on their own, but occasionally they remain on the ovary and may need to be removed if they grow large or cause symptoms.

Another form of cyst that you had before becoming pregnant could still be present. It could remain on your ovary when you are expecting. While some cysts may even enlarge and become painful during pregnancy, most don’t harm the unborn child.

Ovarian Cyst Symptoms During Pregnancy

Most cysts don’t cause pain or other visible symptoms. But there are some ovarian cysts that can cause the following symptoms:

  • Pain

You can experience pain in the lower abdominal or pelvic area on the side the cyst is located. The intensity of the pain can vary. It can be sharp or may even feel like a twinge. In rare cases, an ovarian cyst can cause the ovary to twist (called torsion). This can get extremely painful.

  • Bloating

It is usually caused by excess gas production or disturbances in the movement of the muscles of the digestive system. This can not only make your stomach look big, but also make you feel bloated.

Lower abdomen pain on one side that comes and goes is typically a symptom of ovarian torsion. It could also lead to:

  • Nausea
  • Vomiting
  • Minimal fever

Ovarian torsion is an urgent medical situation. If you suspect that you may have this condition, visit the emergency room right away.

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In the case of a ruptured ovarian cyst, the pain will become intense and may also get unbearable.

Pregnancy-related ovarian cyst ruptures are most likely to occur in the first or early second trimester and spontaneously resolve by the middle of the second trimester.

Here are some other symptoms to look for-
  • Nausea or vomiting, along with pain (in the case of a torsion)
  • Vaginal bleeding or spotting
  • Dizziness, along with pain
  • Fever, along with pain

You should not neglect any of the symptoms and immediately rush to the doctor to avoid any further complications. 

What will happen if I have an ovarian cyst during pregnancy?

Although ovarian cysts often don’t create issues during pregnancy, they could rupture, distort, or cause the ovary to twist if they continue to grow. Growing cysts may provide challenges during labour, especially if they form a big mass that blocks the pelvis or abdomen.

Regular ultrasounds will be performed by your caregiver to keep an eye on your ovaries and the cyst and make sure it doesn’t enlarge or pose a hazard to your health. You might get an MRI if an ultrasound is insufficient for examining a cyst that is producing issues.

Do ovarian cysts during pregnancy disappear?

Cysts in the corpus luteum typically vanish on their own during the second trimester. And the majority of ovarian cysts during pregnancy are unharmful.

But be sure to let your doctor know if you’re in pain or have any other symptoms. Safe pregnancies and healthy babies can be achieved with careful monitoring and appropriate pain management.

Is Normal Delivery Possible With Ovarian Cyst?

Image from iStock

Early scans frequently reveal ovarian cysts, which are typically uncomplicated lesions. The majority vanish after 20 weeks, but not in your case.

They are not malignant, but if they become large or exhibit symptoms, they may become an issue. Your doctor will monitor the cyst with more scans in an effort to delay surgery on it until after the birth of your child.

When you’re getting close to your due date, your doctor may implant a needle and drain the cyst if it grows to such a size that it inhibits the baby’s head from engaging in your pelvis.

You should be able to give birth naturally if this is successful.

A few months after the birth of your child, your doctor can do keyhole surgery to remove the cyst. However, medical professionals will be able to remove the cyst concurrently if you require a C-section for another reason.

Treatment for Ovarian Cyst During Pregnancy

Ovarian cysts are typically not treated. They leave by themselves. Unless:

  • You have an ovarian cyst that ruptures. You’ll probably require pain medicine in this situation. The ruptured cyst will often be absorbed by your body, but your doctor will advise rest and keep an eye out for any signs of infection.
  • You have an ovarian torsion. Surgery is necessary since this is a medical emergency.
  • The cyst is large or causing symptoms. Your caregiver might advise rest and conceivably even surgery.

Removing Ovarian Cyst During Pregnancy

If you are lucky, your ovarian cyst may disappear on its own and you will not need any treatment. But, if your doctor feels that surgery is required during pregnancy, they will have to do it.  Yes, it is quite natural for you to panic in this situation, but remember that a doctor will always take the best decision for you and your baby.

The excision of an ovarian cyst during pregnancy is safe if necessary, but your caregiver will likely wait until you are in pain or the cyst is bleeding before performing the procedure. If you require surgery, you might be eligible for minimally invasive laparoscopic procedures using small incisions.

Chances are that they will try to go for laparoscopy surgery. In this procedure, the surgeon creates a very little incision above or below the belly button to view the pelvic region and remove the cyst. For smaller cysts that appear benign (not malignant) on the ultrasound, this is frequently advised.

But, if the cyst is large, surgery using laparoscopes may not be possible, and regular abdominal surgery will be required.  Next, the cyst is examined for malignancy. A gynecologic oncologist should be consulted if it is suspected to be malignant since they may need to remove the ovary and other tissues, such as the uterus.

If you are thinking of removing an ovarian cyst during pregnancy through surgery, factor in the cost as well.  For instance, cyst removal in Singapore can cost around $4,413.
 
After going through the surgery, you will also need to take care of your health. Here are some tips to help you in your post-surgery recovery. 

5 Tips To Help You Recover From Surgery Stress

  • Change the bandage frequently

You need to keep the wound covered with a dry bandage. There may be some drainage for a few days, so change the bandage as advised. If the gauge was placed in the wound, then you may again be required to go visit the doctor’s office for removal.

  • Get enough rest

Sleep is one of the most important factors that can help you recover fast. If you have had surgery, you need to take good rest and sleep for a minimum of 8 hours per day. Try and look for ways in which you can relax. Listen to music, watch your favourite show, and spend time with your partner. 
Relaxation techniques, such as meditation, yoga, and deep breathing, may help relieve anxiety and reduce stress.

  • Eat healthily

Post-surgery recovery also to a large extent depends on your diet. Chances are high that your appetite has reduced and you don’t feel like eating anything. But, you can’t afford to do that. Your body requires healthy food to recover from the surgery stress. 

  • Take your medicines on time

Take all the prescribed medications on time. Finish the entire course, even if your wound looks healed. Use antibiotic creams or ointments, as advised. As an added precaution, confirm with your healthcare provider if the prescribed medication is safe for pregnant mums before taking them. 

  • Don’t hesitate to ask for help

It is not possible for you to complete all the household chores and balance work and pregnancy with surgery. So don’t hesitate to ask for help. Call on your family members, friends or keep a house help. Talk to your partner and communicate your discomforts honestly. 
 
We understand that pregnancy is a beautiful journey, but it can also be equally stressful. Amid all the chaos to welcome your newborn safely, don’t forget about your health. 
 
Updates by Matt Doctor

Women’s Health, Healthline

Here at theAsianparent Singapore, it’s important for us to give information that is correct, significant, and timely. But this doesn’t serve as an alternative for medical advice or medical treatment. theAsianparent Singapore is not responsible for those that would choose to drink medicines based on information from our website. If you have any doubts, we recommend consulting your doctor for clearer information.

Written by

Sarmistha Neogy