Second Trimester Spontaneous Regression Of Theca Lutein Cysts
Obstetrics and Gynecology 60(1): July 1982; 124-126
View Original Source →Abstract
Two patients with sonographically documented fetal ascites are described. Workup for immunologic or nonimmunologic causes was negative. Subsequent sonar examinations demonstrated disappearance of fetal ascites. At delivery, previous abdominal distention was apparent. Fetal ascites of unknown etiology in the late second trimester does not necessarily have a poor prognosis. Serial sonographic examinations are indicated for follow-up of fetal ascites.
Case Details
Personal Characteristics
The patient, a 20-year-old white woman, gravida 2, para 0, abortus 1
Clinical Characteristics
She complained of a persistent dull ache in the right lower quadrant. On examination, the uterus was found to be enlarged to approximately 16 weeks gestational size. A tender irregularity was palpable posteriorly and to the right. The possibility of a uterine myoma was considered. An ultrasound scan was performed, and a twin gestation, consistent with the patients menstrual dates, was identified. Also noted was a large septated transonic mass posterior to the uterus. Longitudinal and transverse scans showed a mass measuring 10 centimeters in length, 6 centimeters in its anteroposterior diameter, and extending approximately 6 to 7 centimeters on either side of the midline. The mass was interpreted as typical of bilateral theca lutein cysts. During a repeat pelvic examination, an irregular cystic mass, separate from the large gravid uterus, could be appreciated fill-ing the posterior cul-de-sac. During subsequent weeks, the patients lower abdominal discomfort gradually subsided. Eight weeks after her initial evaluation, the mass was no longer palpable on pelvic examination. A repeat ultrasound scan confirmed that the bilateral multilocular cysts were no longer present.
Remission Characteristics
Eight weeks after her initial evaluation, the mass was no longer palpable on pelvic examination. A repeat ultrasound scan confirmed that the bilateral multilocular cysts were no longer present.
Treatment & Mechanisms
Proposed Remission Mechanisms
Not discussed
Clinical Treatment
Low vertical cesarean section
Additional Notes
The pregnancy subsequently proceeded uneventfully until 32 weeks gestational age, when the patient presented in advanced premature labor. The first twin was in breech presentation, and the patient underwent a low vertical cesarean section and was delivered of 2 normal female infants weighing 1,115 and 1,310 g.rams At operation, both ovaries were noted to be normal in size and appearance.