OP07.03: Decidualised ovarian cysts in pregnancy: ultrasound features and management

It is a retrospective study aimed at determining the safety of conservative management of ovarian cysts detected during pregnancy with the onset of decidualisation. Between 2016 and 2022 we selected 11 pregnant women presenting at first ultrasound evaluation at least one ovarian cyst with the characteristics of decidualisation: the appearance of smooth and highly vascularised internal solid parts that can mimic the presence of malignancy. We looked to the history of known endometriomas or at least a pregravidic symptomatology that could contribute to the suspicion of the presence of endometriosis. 6 out of 11 women had previous ultrasound evidence of pregravidic endometriomas; three reported symptoms of dysmenorrhea and/or dyspareunia during menstrual cycles; two did not provide any clinical or imaging data suggesting for the presence of endometriosis. All of them were followed-up with ultrasound every two months throughout the pregnancy and after delivery and none of them were referred to surgery. Some of them disappeared during the third trimester or after delivery. Changes in pregnancy of an ovarian endometrioma characterised by the development of solid intracystic areas that mimic malignancy can occur. The knowledge of the ultrasound modifications of endometriomas, that are not rare to be found in a woman's lifetime, can allow a wait-and-see management towards surgery especially in the presence of a positive history of endometriosis. Please note: The publisher is not responsible for the content or functionality of any supporting information supplied by the authors. Any queries (other than missing content) should be directed to the corresponding author for the article.