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Peritoneal Inclusion Cyst: Effects on Fertility and Antepartum Course

Vallerie, Amy M. MD; Hsieh, Tiffany MD; Baxi, Laxmi V. MD

doi: 10.1097/AOG.0b013e3181809e5c
Case Reports

BACKGROUND: Hormone changes are thought to influence the etiology and disease process of peritoneal inclusion cysts. The effects of fertility and pregnancy on preexisting cysts are unknown.

CASE: A 29-year-old woman with recurrent peritoneal inclusion cyst and primary infertility conceived spontaneously after hysterosalpingogram. She presented in the first trimester with rapid, symptomatic enlargement of a 22-cm peritoneal inclusion cyst. Ultrasonogram-guided aspiration was performed. The remainder of her pregnancy and postpartum course were uncomplicated.

CONCLUSION: The presence of a large peritoneal inclusion cyst does not preclude fertility. Pregnancy, a hyperestrogenic state, together with rising human chorionic gonadotropin is a risk for recurrence or enlargement of a preexisting peritoneal inclusion cyst. After conservative management with cystocentesis, there was no further enlargement as pregnancy progressed.

Decompression of a large peritoneal inclusion cyst, which had significantly enlarged in the first trimester, allowed the patient’s pregnancy to progress normally.

From the Department of Obstetrics and Gynecology, Columbia University College of Physicians and Surgeons, Columbia University Medical Center, New York, New York.

Corresponding author: Laxmi V. Baxi, MD, 622 West 168th Street, Department of Obstetrics and Gynecology, Columbia University Medical Center, New York, NY 10032; e-mail:

Financial Disclosure The authors have no potential conflicts of interest to disclose.

© 2008 The American College of Obstetricians and Gynecologists