2 anechoic cyst are seen in left adnexa during 6 weeks 6 days of pregnancy in ultrasound. Is it affect for child growth or birth??
Answers
Answer:
No There is No problem.
Only Few possible Problems in pregnancy
Answer:
Adnexal masses in pregnancy are not commonly encountered. The majority of these masses are discovered incidentally during routine follow-up. However, some of these masses become symptomatic due to their size, location, and impingement of adjacent structures. Several diagnostic modalities can be utilized for the detection of adnexal masses with different sensitivity and specificity rates. The differential diagnosis of adnexal masses discovered during pregnancy is broad and includes both benign and malignant lesions. The management of such lesions has been a subject of debate for years with no consensus regarding the best management plan. Tumor size, site, and the trimester of mass detection are all crucial in management. In this account, we review adnexal masses discovered in pregnancy, the diagnostic modalities utilized for detecting these lesions, their differential diagnosis, and management strategies.
Key words: Most adnexal masses discovered during pregnancy are incidental findings revealed on routine pregnancy investigations.[1,2,3,4] Previously, the detection rate of such masses was low, owing to the lack of technological advancements that facilitated early detection.[1] The detection of adnexal masses was predominantly based on clinical examinations of the adnexa, which underestimated their incidence during pregnancy. However, the incidence and detection rates of adnexal masses have increased tremendously with the application of ultrasonography in pregnancy follow-ups.[1,3,5] According to a recent study, adnexal masses are discovered in 1 per 76–1 per 2328 deliveries.[6]
In general, the majority of adnexal masses are discovered in the first two trimesters of pregnancy. Those that are functional regress spontaneously whereby 65%–80% of patients remain asymptomatic.[6] Nonetheless, to prevent complications related to mass torsion, rupture, labor obstruction, and malignancy, masses that persist beyond the first trimester or are first noted in the second trimester are usually resected.[6,7] Malignancy is usually associated with the presence of symptoms; an abdominal mass is the most common complaint in patients with adnexal malignancy.[6]
DIAGNOSTIC EVALUATION
According to the ACOG guidelines, pelvic examinations have limited ability to identify adnexal masses, especially in patients whose body mass index is >30 kg/m2, making it less reliable for detection and diagnosis.[8] Pelvic ultrasonography, however, is considered the modality of choice for evaluating adnexal masses discovered in pregnancy and is suitable for guiding surgical intervention if indicated.[1,6] Abdominal ultrasound can also be used later during pregnancy to investigate the possible displacement of the ovaries into the abdominal cavity. Ultrasonography is also important in monitoring adnexal masses to determine their progression or regression in size and character.[1] In addition, Doppler ultrasound can also be employed for further characterizing the lesion in relation to the blood flow.[1,5] It is thus important to note the different ultrasonographic features of various etiologies. Some features on ultrasound may raise the suspicion of malignancy, which include, but are not limited to the presence of solid components, multiloculated large tumors with increased wall thickness and maximum diameter >6 cm, gross internal septa (>2–3 mm), papillary projections, decreased resistance in blood flow during Doppler examination, or free abdominal/pelvic fluid. Further investigation with magnetic resonance imaging (MRI) helps obtain better morphological characteristics of the suspicious lesion.[5,6,8,9] Based on the ultrasound morphology, adnexal masses are categorized into high-, intermediate-, and low-risk groups. High-risk masses have features of malignancy such as being solid, nodular, with thick septations. Intermediate-risk masses are not anechoic and/or unilocular but do not have features of malignancy. Low-risk masses are anechoic unilocular fluid-filled cysts with thin walls.[10] It is worth noting that some lesions that have benign features on ultrasound, eventually turn out to be malignant at the time of surgery. Therefore, although false-negative ultrasonographic results are uncommon, they still can occur.[11]