March 2022 · Volume 11 · Issue 3 Page 965 International Journal of Reproduction, Contraception, Obstetrics and Gynecology Balasubramanian KK et al. Int J Reprod Contracept Obstet Gynecol. 2022 Mar;11(3):965-968 www.ijrcog.org pISSN 2320-1770 | eISSN 2320-1789 Case Report Torsion of in-utero fetal ovarian cyst Kruthiga Kumari Balasubramanian*, Lalitha Natarajan, Paavai Arunachalam, Latha Maheshwari INTRODUCTION Multidisciplinary teamwork is essential to provide the best possible care for patients. This report describes the management of a pregnant woman who was diagnosed with a fetal hemorrhagic abdominal cyst, which can lead to severe complications if not treated timely. This is an interesting, rare case and useful for learning experience. Ovarian cyst is a fluid filled sac within the ovary, mostly asymptomatic and harmless. The incidence of fetal ovarian cysts detected in utero has increased over the past decade (1 in 2600 pregnancies) due to increased use of ultrasound, which is usually diagnosed at the end of second and third trimester scans. Stimulation of fetal ovary by placental and maternal hormones leads to development of ovarian cysts, and usually regress shortly after birth once hormonal stimulation has decreased. 1 Ovarian cysts can be simple cysts which are completely anechoic in ultrasound, while complex cysts have an echogenic wall, internal septae, debris and blood clots and require surgical management. Complications include torsion, hemorrhage, recurrence, preterm labor and rupture. 2 From this study, it can be concluded that ultrasound scans done antenatally can help diagnose many anomalies in the fetus in-utero, which help in early interventions post- delivery and prevent further neonatal morbidity and mortality. CASE REPORT 22 years old primi gravida, LMP-3/10/20 EDD-10/7/21, non-consanguineous marriage, spontaneous conception, booked and immunized at an outside hospital and undergone regular antenatal checkups, was referred at 38 DOI: https://dx.doi.org/10.18203/2320-1770.ijrcog20220589 Department of Obstetrics and Gynaecology, PSG Institute of Medical Sciences and Research, Coimbatore, Tamil Nadu, India Received: 17 January 2022 Revised: 09 February 2022 Accepted: 10 February 2022 *Correspondence: Dr. Kruthiga Kumari Balasubramanian, E-mail: sweet6hopes@yahoo.com Copyright: © the author(s), publisher and licensee Medip Academy. This is an open-access article distributed under the terms of the Creative Commons Attribution Non-Commercial License, which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. ABSTRACT A 22 years old primi-gravida was diagnosed to have a 6.3×5×5.37 cm hemorrhagic gonadal cyst in fetus at 38 weeks of gestation by growth scan, on follow-up. At term gestation, she delivered a female baby by vacuum assisted vaginal delivery, weighed 2.86 kg, no other anomalies. X-ray done at 1st hour of life showed mass on the right side. USG abdomen done showed an intraperitoneal cystic lesion (5.7×3.9×6.3 cm) in right lumbar quadrant of abdomen and pediatric surgeon was consulted. Baby taken for diagnostic laparoscopy on second day of life. Findings were right large ovarian cyst with torsion with adhesions to small bowel. 75 ml of hemorrhagic fluid drained and ovarian cystectomy done, sample sent for histopathological examination, turned out to be a simple cyst. Baby discharged on day 7 of life (POD-5), hemodynamically stable and on direct breast feeding, tolerated well. Keywords: Hemorrhagic gonadal cyst, Torsion, Diagnostic laparoscopy