Dermoid Ovarian Cyst During Pregnancy

During my pregnancy, I was told I likely had a large cyst on my ovary and that it needed to be removed either during the pregnancy or after. Of course, like many people, I turned to Google for advice (don’t judge – we all make mistakes). I found a bunch of second-hand stories about cysts of all types during pregnancy and they almost all had bad endings. I can’t speak to the accuracy of those accounts, but I’m here to share my first-hand experience with a happy ending!

My first pregnancy started out a bit complicated. I received a phone call from my OB shortly after my first ultrasound letting me know that they had discovered a cyst on my ovary and I needed a follow-up ultrasound. Of course, I hung up the phone and immediately started Googling. During my reading, I discovered that a cyst is closely related to a tumor. It wasn’t much of a jump for me to panic about the newly found tumor inside my abdomen ( A lot of us have aliased “tumor” to “cancer” in our lives, and in the middle of becoming hormonal and a first-time pregnancy, that alias was a major concern.

I called my husband and we met in the parking lot (we worked in the same building) where I updated him on what little information I had. We cried together and then decided to wait for more information before going off the deep-end. The second ultrasound confirmed the existence of the cyst and due to its size (10 cm!!!) my OB recommended surgical removal during the second trimester. Fun fact: a bagel is about 10 cm in diameter. We nicknamed the cyst “The Bagel.”

At this point, my husband and I had about 5 weeks to decide what to do. We visited another OB who really provided no further information or guidance. Then, we spoke with a specialist recommended by my cousin. The specialist calmed almost all of our fears. He recommended the surgery in the second trimester as well and discussed the possibility of losing the ovary and any ramifications that might have later in life (very, very few surprisingly). After three doctor visits, lots of reading, and a ton of discussion, my husband and I decided surgery was the best option.

It boiled down to picking the option that gave us the most control over the risks. None of the options avoided risk, but surgery in the second trimester gave us the most control. My OB recommended the surgery during the second trimester as it put us past the high miscarriage risks of the first trimester, but avoided the pre-term labor risks of the third trimester. Additionally, he said general anesthesia was risky to the baby, so instead he’d do a spinal and I would be awake for the surgery. He also recommended a C-section-like incision as it would allow him to save the ovary and ensure there were no signs of a cyst on the other ovary. I also had to take 4 weeks off of work as I was not supposed to sit for long periods of time after the surgery. If we had waited to do the surgery after delivery, we risked ovarian torsion. This would mean emergency surgery and losing the ovary. Depending on when this happened, we may have ended up having to deliver the baby early, which presents its own additional set of risks. In all events, there were risks to the baby, to me, and to possible future child-rearing.

The surgery itself was as uneventful as you can hope. My husband was able to stay with me right up until they wheeled me into the operating room. From there, a nurse took over and did an amazing job walking me through everything that was happening. The anesthesiologist told me to let him know if I started getting panicky as he had medications to help me remain calm, but they weren’t the best for the baby, so he didn’t want to give them to me unless I needed them. Luckily, I was able to remain calm and even talked with the nurses and doctors during the surgery. I opted not to see the cyst as I was worried it would cause me to panic. I think this was the right choice, but I wish I could have seen it.

The recovery left something to be desired. As soon as the spinal wore off, I had to get up and walk around the hospital floor. This may have been the most painful thing I have ever done (and I am including labor in that comparison). I really take my ab muscles for granted. I could not get out of bed without the help of my husband and a nurse, sitting on the toilet brought tears to my eyes and sleep was all but impossible (I am a stomach sleeper and had to sleep on my back). Unfortunately, we lived on the third floor of our apartment building. It took my husband and me about 20 minutes to get up the stairs. For about a week my husband had to help me do everything. We joke about how we went from newlyweds to an old married couple so quickly. He literally had to bathe me, sit me on the toilet and help me up (thank God I could wipe myself), get me in and out of bed, and dress me. Eventually, I gained a little strength back and my husband bought me a walker so I could get up and down on my own. I needed help getting out of bed for a few weeks, but was able to do everything else on my own in a week or two.

At my post-op follow-up appointment, it was confirmed that the cyst was a benign (non-cancerous) dermoid cyst filled with fat and hair. We also learned that we are born with dermoid cysts, they don’t just randomly appear, but they also don’t always grow so large. There was no further cause for concern as my OB had removed all trace of it from my ovary and the other ovary was clear. I went on to have a mostly uneventful pregnancy. For all the concern about pre-term labor later on and any other risks, I went 2 days past my due date and gave birth to an almost 9lb baby. Baby and I have experienced zero negative long-term effects from the surgery (autism, ADD, ADHD, etc.). My husband and I absolutely believe we made the right choice doing the surgery during the second trimester, but it’s a decision we hope to never have to make again.

If you are going through a similar experience or know someone that is, please reach out. The internet is full of terrible, scary information. Much of it is vague and wrong. No matter what you do, find competent doctors, and talk to them. Talk to people who have lived through it. Do not rely on chat forums of second-hand stories. In all likelihood, you and your baby will be just fine!

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