It’s common for women of childbearing age to get ovarian cysts, and it’s not unusual for moms-to-be to find out they have an ovarian cyst while they're pregnant.
Fortunately, the vast majority of ovarian cysts are harmless and do not cause issues in pregnancy. Here’s what you need to know about ovarian cysts during pregnancy.
What is an ovarian cyst?
An ovarian cyst is a fluid-filled sac located within the ovary itself. Ovarian cysts are common — many women have them — and the good news is that most ovarian cysts are harmless, don’t cause pain and resolve on their own after four to six weeks
The two most common types of ovarian cysts are called functional cysts and include:
- Follicular cysts. Follicular cysts form when an ovarian follicle (the tiny sac where the egg grows) doesn't actually release the egg as it should at the time of ovulation, and it continues to grow and accumulate fluid.
- Corpus luteum cysts. A corpus luteum develops after an egg is released from a follicle during ovulation. The follicle sac shrinks into cells that produce hormones to support the rest of the menstrual cycle, or, in the case of a pregnancy, to support the growing baby. If fluid collects in the empty follicle and the sac doesn’t shrink, however, a cyst forms.
Other, less common, types of ovarian cysts are called pathological cysts and include:
- Dermoid cysts. Also called teratomas, these cysts are made up of ovarian germ cells and can contain teeth, hair, skin or fat. They exist from birth, but they're often not discovered until later in life.
- Endometrioma, or "chocolate cysts," exist in women who have endometriosis. These cysts are filled with endometriotic fluid or blood, so they can appear darker in color. They may be painful.
- Cystadenomas cysts. These can develop on the surface of the ovary. They tend to be quite large in size and solid.
What causes an ovarian cyst during pregnancy?
During pregnancy, the corpus luteum produces hormones to nourish and support the uterine lining and the growing baby until the placenta takes over at around 10 weeks. But in a small number of pregnancies, the corpus luteum fills with fluid and remains on the ovary instead of regressing. This is called a corpus luteum cyst.
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Sometimes, sonograms you receive during pregnancy reveal another type of ovarian cyst that you had before you became pregnant.
What should I do if I have an ovarian cyst during pregnancy?
The majority of ovarian cysts won’t affect your pregnancy at all. For instance, when it comes to a corpus luteum cyst, chances are it will go away on its own by the second trimester.
Other types of cysts can continue to grow during pregnancy, and in some cases, may cause pain, but even in those cases, such cysts usually don’t cause problems for the pregnancy.
To be sure that an ovarian cyst doesn’t impact your pregnancy and to monitor any existing cysts, your doctor will schedule regular ultrasounds to monitor your ovaries. An ovarian cyst ultrasound will track the size and condition of any cyst to make sure it doesn’t grow or change in a way that may make it worrisome.
Ovarian cyst symptoms
While most cysts don’t cause symptoms, some ovarian cysts can lead to the following:
- Pain can occur in the lower abdominal or pelvic area on the side the cyst is located. Such ovarian cyst pain can be sharp or dull in nature. It may feel like a twinge or come and go. If an ovarian cyst ruptures, the pain may be more moderate or sudden and severe. In rare cases, an ovarian cyst can cause the ovary to twist (called ovarian torsion). This can be extremely painful, and it requires emergency surgery to untwist the ovary.
- Bloating
- Abdominal fullness or pressure
Ovarian cyst treatments
Most ovarian cysts disappear on their own and don’t need any treatment. In rarer cases, such as in the case of an ovarian cyst rupture or ovarian torsion, the following treatment may be warranted:
- Rest
- Pain medication
- Surgery. If surgery is necessary during pregnancy, your doctor will make every effort to perform the surgery laparoscopically (through tiny incisions in the umbilicus and abdomen). If the cyst is large, laparoscopic surgery may not be possible, and you may need open abdominal surgery (laparotomy) instead.
What if my ovarian cyst bursts during pregnancy?
Usually a ruptured ovarian cyst, even during pregnancy, isn’t cause for alarm. The fluid from the cyst will reabsorb on its own with time, and all that is needed is some medication to manage any discomfort and pelvic rest for a few days.
In fact, most doctors recommend watchful waiting (which involves observation, ultrasounds and monitoring) as the preferred treatment for ruptured ovarian cysts during pregnancy.
However, your doctor may recommend surgery if there is:
- A risk of an infection due to the rupture
- A lot of bleeding
- Torsion
- Another impact on the pregnancy in some way
Burst ovarian cyst symptoms
Not all women feel pain after a ruptured ovarian cyst, but some do feel pain when the rupture occurs. Symptoms of a ruptured ovarian cyst may include:
- Moderate to severe pain. In some cases, a ruptured ovarian cyst can result in a significant amount of pain. It can be sharp and sudden, and the pain can be located in the lower abdominal area or even the back.
- Vaginal bleeding or spotting
- Nausea or vomiting (in the case of a torsion)
- Dizziness
- Fever
Do ovarian cysts during pregnancy disappear?
Corpus luteum cysts usually disappear by themselves during the second trimester. And most ovarian cysts during pregnancy are harmless.
But if you’re experiencing pain or have any other symptoms, be sure to let your doctor know. Careful monitoring and pain medication as needed can help keep your pregnancy and baby safe.
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