Outcome of first‐trimester fetal abdominal cysts: cohort study and review of the literature

Abstract

Objectives The aims of this study were to ascertain the outcome of fetuses with an abdominal cyst detected at 11–14 weeks' gestation in our unit and to undertake a review of cases reported in the literature. Methods This was a retrospective study that included all fetuses found to have an abdominal cyst on ultrasound examination at 11–14 weeks, identified over a 14‐year period. Pregnancy management and outcome were ascertained from maternal and neonatal records. We also performed a review of the literature using a systematic search strategy, to identify the outcome of similar cases and propose a management algorithm. Results Fourteen cases were identified during the study period, of which four had associated abnormalities. Of the 10 isolated cases, the cyst had resolved at follow‐up scan in eight (80.0%), one fetus died in utero at 15 weeks' gestation and the other case underwent surgery for a choledochal cyst 9 weeks after birth. An additional 19 cases were reported in the literature. In eight fetuses there were associated structural abnormalities, of which four had a diagnosis of anorectal malformation after birth. In two of these four, the cyst resolved in the second trimester. Of those cases with an isolated cyst (n = 11), the cyst resolved in seven (63.6%). The remainder were variably diagnosed as hepatic cyst, ileal duplication or choledochal cyst. Conclusion Fetal abdominal cysts at 11–14 weeks' gestation are rare. They constitute an isolated finding in the majority of cases and are usually associated with a good perinatal outcome. In view of the reported association with anorectal and other gastrointestinal malformations, perinatal assessment is recommended, even if the cyst resolves during pregnancy. Copyright © 2013 ISUOG. Published by John Wiley & Sons Ltd.