# Management of Dermoid Cysts During Pregnancy: A Retrospective Analysis From a Tertiary Care Center

## TL;DR

This study examines how dermoid cysts during pregnancy are managed, finding that expectant management is often safe and laparoscopic surgery in the second trimester has good outcomes.

## Contribution

The study provides insights into managing dermoid cysts during pregnancy in a resource-constrained setting using a large retrospective cohort.

## Key findings

- Most dermoid cysts in pregnancy can be safely managed expectantly without surgery.
- Laparoscopic cystectomy in the second trimester is safe and associated with favorable maternal and fetal outcomes.
- Perinatal outcomes were comparable between conservatively and surgically managed cases.

## Abstract

Background

Dermoid cysts, or mature cystic teratomas, are the most common benign ovarian neoplasms in women of reproductive age and are frequently encountered during pregnancy. Their management poses unique challenges, requiring a balance between maternal-fetal safety and risks of surgery. Evidence from Indian tertiary care centers remains limited. This study aimed to evaluate the clinical profile, management strategies, and maternal-fetal outcomes of dermoid cysts in pregnancy.

Methods

This retrospective observational study included 87 pregnant women diagnosed with dermoid cysts over six years at Maharaja Agrasen Medical College Agroha, Hisar (Haryana), a tertiary care center in North India. Demographic data, clinical presentation, ultrasonographic findings, cyst characteristics, management approach, operative details, and maternal and perinatal outcomes were analyzed. Comparisons between conservatively and surgically managed groups were performed using Chi-square/Fisher’s exact test and Student’s t-test as appropriate.

Results

The mean maternal age was 27.8 ± 4.6 years, and the majority of patients were diagnosed during the second trimester 55 (63.2%), predominantly through routine antenatal ultrasonography. The mean cyst size was 6.8 ± 2.7 cm, with torsion observed in 9 (10.3%) of cases. Conservative management was employed in 53 (60.9%), while 21 (24.1%) required antenatal surgery, predominantly laparoscopic cystectomy in the second trimester. Intraoperative complications were rare, and no malignant transformations were observed on histopathology. The mean gestational age at delivery was 38.1 weeks, with preterm birth in 14 (16.1%) of cases. Perinatal outcomes, including birth weight, NICU admission, and mortality, were comparable between conservatively and surgically managed groups.

Conclusion

Most dermoid cysts in pregnancy can be safely managed expectantly. When surgery is indicated, laparoscopic intervention during the second trimester is safe and associated with favorable maternal and fetal outcomes. These findings support a risk-stratified, individualized management approach, particularly relevant in resource-constrained settings.