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Discussion Starter · #1 ·
last week, hours before we leff for vacation, my midwife calls me to tell me that the pain i have been complaining about for the past 2 months is most likely to be caused my a growing dermoid cyst. first of all - ewwwwww<br><br>
i have an appointment to meet with the chief of ob/gyn monday to discuss my options, but the midwife said that i would most likely have to have surgery on my ovary BEFORE the baby is born...<br><br>
has anyone been through this?<br>
does anyone have any links to papers about the effects of anestesia on a fetus that they could send me?<br><br>
i am so overwhelmed and scared.
 

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First of all, <img alt="" class="inlineimg" src="http://www.mothering.com/discussions/images/smilies/hug.gif" style="border:0px solid;" title="hug">...<br><br>
I had cysts in my last pg and I have cysts this time around. They are (I believe) simple cysts... just smooth, fluid-filled cysts. The dermoid ones actually grow tissue-like stuff, right?<br><br>
I don't know how the prognosis for your cyst differs from my cysts, but I can tell you that surgery on ovarian cysts during pregnancy isn't an unheard-of thing. I know of one woman IRL who had it done, and I PM'ed with a couple of women here at MDC about it (they had it done) when I was pg last time. I think the best time to do it is early-mid 2nd tri... your uterus gets more "irritable" as it gets bigger (late 2nd tri and 3rd tri), and early-mid 2nd tri is supposed to be safest.<br><br>
I was scheduled for surgery on my cysts last time (because they were causing me a lot of pain and growing pretty rapidly, whole mass got to be softball-sized at the largest point), but I was able to cancel it after a bunch of them ruptured ~16 weeks (ouch--conveniently right before my 2nd opinion u/s and a week or so before the date of the surgery). I really recommend getting a 2nd opinion (from a perinatologist, if possible) and/or discussing whether just monitoring the cyst via u/s through your pg is a possibility. My remaining cysts were monitored through the rest of my pg (and ~ 1/2 ruptured during the pushing stage--ouch!). I'm just hoping that when I'm done with this pg (my last kid), they'll go away for good. I would have received a spinal for the surgery, I believe, and yes, I would have been awake through the whole thing (kind of like a cesarean).<br><br>
Take this with a grain of salt... I know that with my type/size of cysts, a big part of the reason they want to do surgery is because of the risk of ovarian torsion (the cyst(s) and ovary are "big", more prone to twist on the ovary's stalk and cut off the blood supply to the ovary, which generally requires immediate emergency surgery). You might want to ask why surgery is recommended, what the risk is of *not* having the surgery.<br><br>
You should definitely ask for another u/s on Monday--you want to confirm what was seen, see if there's any diff. in size. Also, you should ask about laproscopic surgery. Not everyone does it this way, but obviously, when you're pg, if you *have* to have the surgery, you want as easy a recovery as possible. Another thing to ask is about the status of your ovary. My ob told me she would not have removed my ovary unless she absolutely had to--just the cysts. Again, not all drs. do it this way. (For me, maintaining my fertility was important.)<br><br>
Try not to worry until you get more information. I know it's really easy to get freaked out about it (seriously, I've been there, not worth it), but you may well be able to avoid the surgery. I'm sorry you're going through this... try to relax this weekend.ddddv
 

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Discussion Starter · #3 ·
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<div>Originally Posted by <strong>KKmama</strong></div>
<div style="font-style:italic;">First of all, <img alt="" class="inlineimg" src="http://www.mothering.com/discussions/images/smilies/hug.gif" style="border:0px solid;" title="hug">...<br><br>
I had cysts in my last pg and I have cysts this time around. They are (I believe) simple cysts... just smooth, fluid-filled cysts. The dermoid ones actually grow tissue-like stuff, right?</div>
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Yah, nasty real tissue... ugh I can't even think about what could be in there. And these ones just don't go away I guess. I have had a simple cyst in the past too and it also ruptured and went away. Painful, but prolly less so then recovering from surgery.<br><br><br><div style="margin:20px;margin-top:5px;">
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<div>Originally Posted by <strong>KKmama</strong></div>
<div style="font-style:italic;">I think the best time to do it is early-mid 2nd tri... your uterus gets more "irritable" as it gets bigger (late 2nd tri and 3rd tri), and early-mid 2nd tri is supposed to be safest.</div>
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I have read that too somewhere. I am in my 11th week now, so I supose it would be pretty soon, huh?<br><br><div style="margin:20px;margin-top:5px;">
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<div>Originally Posted by <strong>KKmama</strong></div>
<div style="font-style:italic;">I was scheduled for surgery on my cysts last time (because they were causing me a lot of pain and growing pretty rapidly, whole mass got to be softball-sized at the largest point), but I was able to cancel it after a bunch of them ruptured ~16 weeks (ouch--conveniently right before my 2nd opinion u/s and a week or so before the date of the surgery). I really recommend getting a 2nd opinion (from a perinatologist, if possible) and/or discussing whether just monitoring the cyst via u/s through your pg is a possibility. My remaining cysts were monitored through the rest of my pg (and ~ 1/2 ruptured during the pushing stage--ouch!). I'm just hoping that when I'm done with this pg (my last kid), they'll go away for good. I would have received a spinal for the surgery, I believe, and yes, I would have been awake through the whole thing (kind of like a cesarean).</div>
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Wow, softball, huh? Mine was 4 cm 2 weeks ago at the last ultrasound. I just keep praying that it didn't grow and that it is no big deal :)<br><br>
What does a perinatologist cover?<br><br><br><br>
"You should definitely ask for another u/s on Monday--you want to confirm what was seen, see if there's any diff. in size. Also, you should ask about laproscopic surgery. Not everyone does it this way, but obviously, when you're pg, if you *have* to have the surgery, you want as easy a recovery as possible. Another thing to ask is about the status of your ovary. My ob told me she would not have removed my ovary unless she absolutely had to--just the cysts. Again, not all drs. do it this way. (For me, maintaining my fertility was important.)"<br><br>
Oh, I will definetly ask for another ultrasound. My midwife told me that they made the appointment 2 weeks later to track the growth. So, that is somewhat reassuring that they won't rush into things.<br><br>
Thank you so much for replying and sharing your story. I know I can't worry until I know more... but it is so hard!!!
 

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<table border="0" cellpadding="6" cellspacing="0" width="99%"><tr><td class="alt2" style="border:1px inset;">Yah, nasty real tissue... ugh I can't even think about what could be in there. And these ones just don't go away I guess.</td>
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I was pretty wigged out by my body not "working right" and the "thing" that was in me (at one point, my ob was afraid it was cancer, but ovarian cancer is almost unheard of in fertile women under 50). Even though it's hard, I'd really try to focus on the miracle which is your baby. There are so many different kinds of cysts, with so many different prognoses that it's best to just wait till you find out about what's up with yours.<br><br><div style="margin:20px;margin-top:5px;">
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<table border="0" cellpadding="6" cellspacing="0" width="99%"><tr><td class="alt2" style="border:1px inset;">I have read that too somewhere. I am in my 11th week now, so I supose it would be pretty soon, huh?</td>
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Not necessarily... I think I was scheduled for somewhere ~19-20 wks. If it's feasible, you might want to hang back a *little*; it allows more time for more observational u/s; the additional info may allow your dr. to conclude that surgery is not necessary (now or at all).<br><br><div style="margin:20px;margin-top:5px;">
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<table border="0" cellpadding="6" cellspacing="0" width="99%"><tr><td class="alt2" style="border:1px inset;">What does a perinatologist cover?</td>
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They do higher risk pregnancy stuff (I suppose you can think of them as being like OBs but they deal with problems that happen during pg). So a perinatologist should have a better idea of risks, how any potential surgery should be handled, how necessary it is, etc.<br><br><div style="margin:20px;margin-top:5px;">
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<table border="0" cellpadding="6" cellspacing="0" width="99%"><tr><td class="alt2" style="border:1px inset;">Oh, I will definetly ask for another ultrasound. My midwife told me that they made the appointment 2 weeks later to track the growth. So, that is somewhat reassuring that they won't rush into things.</td>
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This is good. It may well be that if it hasn't gotten larger (or if it's the same size), they may decide just to monitor it through your pregnancy.<br><br>
Y'know, during the time I was waiting for my 2nd opinion, there were a lot of people praying and vibing for shrinking of my cysts (and then a bunch ruptured!). I really believe this can help (can't hurt!)... I will be sending shrinking thoughts your way... <img alt="" class="inlineimg" src="http://www.mothering.com/discussions/images/smilies/hug.gif" style="border:0px solid;" title="hug">
 

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Discussion Starter · #5 ·
Y'know, during the time I was waiting for my 2nd opinion, there were a lot of people praying and vibing for shrinking of my cysts (and then a bunch ruptured!). I really believe this can help (can't hurt!)... I will be sending shrinking thoughts your way... <img alt="" class="inlineimg" src="http://www.mothering.com/discussions/images/smilies/hug.gif" style="border:0px solid;" title="hug">[/QUOTE]<br><br><br>
I appreciate it, and all the advice too. Thank you so much!
 

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Try not to worry! The OB may say something completely different from what your midwife said.<br><br><div style="margin:20px;margin-top:5px;">
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<table border="0" cellpadding="6" cellspacing="0" width="99%"><tr><td class="alt2" style="border:1px inset;">Mine was 4 cm 2 weeks ago at the last ultrasound. I just keep praying that it didn't grow and that it is no big deal :)</td>
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My dermoid was roughly the same size (4cm by 3cm) during my first pregnancy, and the radiologist and my OB both assured me that they definitely wouldn't recommend removal before baby was born. If it had been much larger, growing quickly, causing a lot of pain, or if the walls seemed thin, they would have recommended removing it during pregnancy to avoid the emergency surgery that would be necessary if it ruptured. During several follow-up ultrasounds, mine wasn't growing at any measureable rate. Dermoids are almost always very slow-growing.<br><br>
Mine was causing pain, but not terrible. More like twingy, sharp pain that would bother me several times a day. I was told this probably wasn't growth of the dermoid, but more likely irritation of surrouding tissues as the growth of my uterus pushed things around, including my ovary.<br><br>
Hang in there!
 

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Discussion Starter · #8 ·
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<div>Originally Posted by <strong>jplain</strong></div>
<div style="font-style:italic;">My dermoid was roughly the same size (4cm by 3cm) during my first pregnancy, and the radiologist and my OB both assured me that they definitely wouldn't recommend removal before baby was born. If it had been much larger, growing quickly, causing a lot of pain, or if the walls seemed thin, they would have recommended removing it during pregnancy to avoid the emergency surgery that would be necessary if it ruptured. During several follow-up ultrasounds, mine wasn't growing at any measureable rate. Dermoids are almost always very slow-growing.</div>
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This is pretty much what the doctor said on monday. As long as it doesn't get to be 8 cm or so, or looking like it is going to burst, or twist on itself, I can wait to have surgury until after the baby is born.<br><br>
I have another ultrasound on halloween to check things out.<br><br>
This doc btw is way nicer and more chill than my midwife.... does that say something about maybe changing midwives???<br><br>
***<br><br>
Thanks kkmom for asking about me!!!
 

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I had a huge (9 cm) simple cyst during my pregnancy, and I was totally freaked out about it at first and let it dominate the pregnancy, but ultimately, I realized that it wasn't that big of a deal and I went on to have a perfectly normal pregnancy and natural birth at a birth center, and gave birth to a beautiful, healthy baby. I learned that who you talk to matters A LOT and that it's always worth it to get a second or third opinion.<br><br>
The cyst was first diagnosed by a perinatologist at the level 2 ultrasound at four months, and she said surgery would probably be necessary. The ob-gyn I was seeing at the time was a real alarmist jerk to put it mildly, and he pushed hard for the surgery and also scared the bejeezus out of me by talking about how he normally did a hysterectomy if the woman turned out to have cancer, but obviously he wouldn't do that on a pregnant woman, but there were a lot of good results these days with chemo during pregnancy..... OMG!<br><br>
Needless to say, I moved on to another ob-gyn, who was like night and day. She was totally reasonable and talked through the whole situation with me and discussed the pros and cons of surgery vs. waiting with me, and summed it up by saying, "there's a small risk either way, but either way I think you'll be fine." So much better. In my case anyway, the issue with the surgery was that it was optimal to do it early in the 2nd trimester because at that point it could be done laporoscopically, which would be outpatient surgery with a much easier recovery - but by the time they discovered it, my uterus had already expanded too much, and it would have been necessary to have full abdominal surgery, which would have required a hospital stay and longer recovery. So I think that's the issue with the timing, along with the fact that it's optimal for the fetus to do it in that window.<br><br>
Anyway, in my case, since all of the indicators were that the cyst was benign, and I wasn't in any pain and wasn't too keen on the full abdominal surgery, I decided to wait and monitor the cyst through monthly ultrasounds to make sure it wasn't growing or doing anything funky. In the end, I switched to a freestanding birth center run by midwives, and had a great natural, intervention-free birth. So the cyst wasn't even a big enough issue to keep me from being able to deliver in that setting - they said it was a gyn issue, not an ob one, and wouldn't be likely to cause any complications.<br><br>
Ultimately, I ended up having to have the laporoscopic surgery about six months after my baby was born, because the cyst didn't go away - even after having it drained, it refilled. I know of another woman who had the surgery during pregnancy, though, and both she and the baby came out of it just fine. If I had discovered the cyst earlier in the pregnancy, I might have considered having the surgery, just to avoid the drama for the remainder of the pregnancy. Although at this point, knowing that it was really a non-issue, I probably wouldn't opt for the surgery if I developed a cyst in future pregnancies.<br><br>
Oh, you know, one more thing - I went to a Chinese practitioner to see if she might be able to do accupuncture to help shrink the cyst. She examined my tongue and pulses and decided that she didn't want to do accupuncture because she didn't want to risk harming the baby. She looked at me and said, "You're fine, your baby's fine, your problem is you worry too much." And she was right!<br><br>
Anyway, I hope that everything goes well for you. I know how anxiety provoking it can be.
 

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Oh whoops, I started writing my response, then got called away by the phone, and then finished when I got back - and realized too late that you had already posted an update! I'm glad to know that the situation seems to have resolved itself and that the surgery can wait.
 

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Alleybcat, I think that's great news. <img alt="" class="inlineimg" src="http://www.mothering.com/discussions/images/smilies/thumb.gif" style="border:0px solid;" title="thumbs up"> If you *do* think you should check out other MWs, do it now, in early pg (speaking from experience).<br><br>
Margauxmama, that sounded really (unnecessarily) stressful. <img alt="" class="inlineimg" src="http://www.mothering.com/discussions/images/smilies/hug.gif" style="border:0px solid;" title="hug"> Cancer in pg women is so rare, esp. ovarian cancer. Your 1st ob deserves some non-gentle discipline! <img alt="" class="inlineimg" src="http://www.mothering.com/discussions/images/smilies/irked.gif" style="border:0px solid;" title="irked">:
 
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