Ovarian Tumour in Pregnancy: Is Surgery Always Needed?
Most ovarian cysts found in pregnancy are harmless and disappear on their own. Surgery may be needed if the tumour is large, twists or looks suspicious.
In this article 5 sections
Surgery is not always necessary when an ovarian tumour or cyst is found during pregnancy. In most cases these are harmless (not cancer), and many disappear on their own early in pregnancy. However, an operation may be needed if the tumour is large, twists, ruptures or if cancer is suspected. Whether this applies to you is decided through ultrasound and assessment by your doctor. In the video, Dr. Sharmin Afroz briefly explains this topic.
01Why ovarian cysts are found in pregnancy
Because ultrasound scans are done regularly in pregnancy, cysts that were already present or have newly formed are easily detected. The most common is the corpus luteum cyst, which produces hormones in early pregnancy and usually shrinks after the first three months. Dermoid cysts, simple fluid-filled cysts or endometriomas may also be seen. Ovarian cancer in pregnancy is very rare.
02When watching and waiting is enough
If the cyst is small, contains only fluid (a simple cyst) and causes no symptoms, it is usually monitored with ultrasound at set intervals without surgery. Often the cyst disappears on its own or stays the same size, and if needed it can be treated after the birth. During this time it is important to keep up with regular check-ups rather than worry unnecessarily.
03When surgery may be needed
- Twisting (ovarian torsion): if the ovary twists on itself, its blood supply is cut off; this is an emergency and needs prompt surgery.
- Rupture or bleeding into the cyst: when there is severe pain and bleeding.
- Growth: if the tumour keeps growing or may obstruct the birth.
- Suspicious features: if ultrasound or MRI raises concern about cancer.
In an emergency, surgery is done at any stage of pregnancy. For a planned operation, however, the middle part of pregnancy, the second trimester, is generally considered safer. In experienced hands, many of these operations can be done by laparoscopy. Mother and baby are closely monitored before and after surgery.
04Is surgery risky for the baby?
Every operation carries some risk, such as the effects of anaesthesia or the start of early labour. However, not operating when it is needed, especially in torsion or rupture, can be far more dangerous for both mother and baby. So the decision is made jointly by the obstetrician, the anaesthetist and, if needed, the paediatrician.
Many mothers feel anxious when a cyst is found, which is entirely natural. Ask your doctor clearly about the size and type of your cyst and the plan ahead. Keep every ultrasound report and bring them to each check-up so changes in size can be compared easily. Continue follow-up after the birth if advised.
When to see a doctor
If a cyst or tumour is found in pregnancy, keep up with follow-up and have ultrasound scans when your doctor advises. Go to hospital urgently if you notice:
- Sudden severe lower abdominal pain, especially on one side, with vomiting or nausea
- Fever, dizziness or feeling faint
- Vaginal bleeding or leaking fluid
- The abdomen suddenly becoming hard, or regular painful tightenings
- Reduced baby movements
Q & A
Frequently asked questions
Most small, simple cysts do not harm the baby. However, complications such as twisting or rupture need prompt treatment.
Planned surgery is usually done in the second trimester. In an emergency, surgery is performed at any stage.
In many cases, yes. If a large tumour blocks the birth canal, your doctor may advise a different plan.
Article & video by
Dr. Sharmin Afroz
Obstetrics, Gynaecology & Infertility Specialist and Laparoscopic Surgeon
Assistant Professor, Department of Obstetrics & Gynaecology, Anwer Khan Modern Medical College & Hospital.
