It can be a big shock for you finding out you have an ovarian cyst while being pregnant.
You start worrying about the baby and don’t know what to do. But the best advice at the beginning may be to calm down a little bit because the effects of stress can be even worse.
Please consider this: Cysts are not that uncommon during pregnancy. About 1 in 1000 pregnant women have some. And besides, the vast majority of ovarian cysts found during pregnancy are benign. The incidence of ovarian cancer is only 1 in 25000 births.
Normally, your doctor will use ultrasound to find out if the cyst is benign or malignant. The cyst is probably benign if the ultrasound exam shows that it’s strictly fluid-filled, without septation or thick walls.
If you are pregnant and have a cyst that is benign and small you shouldn’t worry too much because it normally resolves on its own. But if your cyst is large (even benign) there is a risk it may rupture or torse (twist on themselves). Either of these events leads to significant pain and the potential for miscarriage or preterm delivery for the baby.
Large (more than 6-8cm) cysts are usually removed surgically if they do not decrease in size spontaneously over the course of a few weeks because they can affect the growth of the baby. In certain cases, a cyst may be dealt with via laparoscopy, but normally (very) large cysts require a large, open incision. Your cyst may also be surgically removed if it is solid or filled with debris, is irregularly shaped or causes severe pain.
The best time to operate is in the second trimester, ideally around 14-16 weeks, because the baby is small. If you decide to wait until the baby is born there can be the risk of an emergency surgery.
If the pain is not that severe a chamomile herbal tea (Matricaria recutita), Echinacea or milk thistle can help as it reduces the pain and soothes tense muscles.
Even if a surgery may be necessary in your case, please try to keep in mind that in the huge majority women who underwent surgery to remove even very large cysts during pregnancy went on to deliver normal, healthy babies.