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Pregnant. Have ovarian cyst. Suggested for TIFFA scan. Should I be worried?

Mar 2016
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Hi My wife is in 5th month of her pregnancy. she has 2 cyst's on her right ovary. She was diagnosed with cyst only after she met the doctor to confirm her pregnancy. She has now 2 cyst on her ovaries which are liquid. She was asked to take a few thyroid tablets also after some test in 2nd month.Now the doctor is asking for TIFFA scan. Do we need to worry.
Posted Wed, 6 Mar 2013 in Women's Health
Answered by Dr. S Patra 1 hour later

Thanks for writing to us. I am trying to give answer according to your concern.

First of all, congratulation to her for being pregnant for the first time.

Ovarian cyst is quite common among the women in reproductive age group. As per your history, two cyst on right ovary may be small functional cyst (more common) or serous type ovarian cyst which contains liquid only. It is simple cyst and nothing to worry as it is neither much enlarged nor give any trouble in pregnancy period.

In addition, if those ovarian cysts are large enough (more than 7 cm) according to ultrasound report, then surgical removal of the cyst i.e. ovarian cystectomy can be done during delivery of the baby by caesarean section after consultation with your obstetrician.

She must need to take thyroid medication throughout the pregnancy period in case of diagnosed hypothyroidism to avoid congenital hypothyroidism & low IQ of the baby. Dose of thyroid medication is needed to be adjusted according to blood TSH level.

TIFFA scan stands for Targeted Imaging For Fetal Anomalies and it is an ultrasonic visualization of fetus in detail. It is done around 18-23 weeks of pregnancy to make sure that there are no major or minor fetal abnormalities/ birth defect that can be diagnosed by ultrasound. It is very much safe and you have nothing to worry.

Please consult with your obstetrician/ sonologist to proceed the TIFFA scan.

Follow some basic things for her healthy pregnancy.

1) Take Healthy protein XXXXXXX diet with extra 350 Kcal/day than usual and eat more vegetables & fresh fruits.
2) Drink lots of fluid/water to stay hydrated & for better feto-placental circulation.
3) Take an adequate bed rest and preferably 8-10 hrs daily in divided schedule.
4) Try to avoid stress/tension/emotional upset by regular XXXXXXX breathing.
5) Maintain personal hygiene including breast & genital care with proper washing.
6) Do periodic check up as per schedule with ultrasound (USG) scan to assess growth & development of fetus.
7) Continue Iron/ calcium supplements till delivery of the baby and up to 6 months after birth of the baby.
8) Take two doses of TT in the 2nd trimester and complete all necessary investigations.
9) Periodic measurement of Weight gain and BP. 10-12 kg weight gain is normal in pregnancy period.

Hope I have answered your query. If you have any further questions I will be happy to help.

Wish her for good health and successful motherhood.

Dr Soumen
Above answer was peer-reviewed by
Follow-up: Pregnant. Have ovarian cyst. Suggested for TIFFA scan. Should I be worried? 16 hours later
Hello Doctor,

Thank you for replying in detail and giving us assurance.

Well, my wife TSH level when diagonsed during 3 month was 6.1 and she was prescribed 50mcg Thyronorm initially for three weeks.

After that we have changed the doctor as she stays vicinity. We have showed all our previous reports and she also said to continue. This month when she visited doctor, she felt the dosage was high and expressed it to her. Doctor then asked her to take 25 mcg Thyronorm without doing a blood sample test.

Is it better to go for a TSH level test presently as she has been taking the hormone for since past two months? She feels taking hormone more than the required amonut is also not good. It a test has to be done Should my wife give a break for a week without taking the hormone prior to the test or she has to continue taking hormone and go for the test. This is my first query.

Secondly, As you have assured cysts can be common I would like to know will here be any problem for the growth of the fetus because of the cyts as the total size of the cysts is approx 6.4cm when scanned.

And due to the presence of cysts does she have a chance to deliver baby normally or caeserean is compulsory for her situation.

Kindly request you clear the above two queries as well and help us to know better to stay happy and peaceful.

Thank you and waiting for your reply.



Answered by Dr. S Patra 1 hour later

Thanks for follow up query. I am happy to help you.

1) Normal blood TSH value during pregnancy for an iodine-sufficient population without any autoimmune antibodies as follows:
First Trimester: 0.24 - 2.99 mIU/ L
Second Trimester: 0.46-2.95 mIU/ L
Third Trimester: 0.43 - 2.78 mIU/ L

We can assume from above chart that her blood TSH level in the first trimester at 6.1 is slight higher than normal range.

Therefore, she must continue taking thyroid medication throughout the pregnancy period without taking a break to avoid several complications (like miscarriages, abruptio placenta, pre-eclampsia, PPH etc.) associated with hypothyroid state.

It is advisable to undergo blood test for TSH level at 3 months interval till it comes in normal range. Till then she will take thyronorm medication at present recommended doses (25 mcg) according to your doctor's prescription. Also she will not stop taking medication when she will undergo for blood test. Even in normal range of TSH, a maintenance dose of thyroid medication is required till the delivery of the baby. Iodized salt with healthy diet is advisable. Also concurrent use of other medication or food stuff like sour fruits/ tea/ coffee etc within 2 hrs of taking thyroid tablet is not recommended.

2) Ovarian cysts at 6.4 cm (total size) are not so serious in this stage as both are simple serous cyst (contains liquid only). It does not hamper/ interfere growth & development of the baby. So you have nothing to worry.

Repeat ultrasound scan is needed in third trimester to assess further enlargement of those cysts to make a decision whether confinement of the baby is undergone through caesarean section or normal delivery. If caesarean section is decided by your obstetrician, then ovarian cystectomy or surgical removal of the cyst can be done in the same time.

If you do not have any clarifications, you can close the discussion and rate the answer.

Be well & take care of her.

Dr Soumen
Above answer was peer-reviewed by
Follow-up: Pregnant. Have ovarian cyst. Suggested for TIFFA scan. Should I be worried? 20 hours later
Hello Doctor,

Thank you for your valuable inputs and guidance.


Answered by Dr. S Patra 8 minutes later

You are most welcome in XXXXXXX platform.

Wish her good health & successful motherhood.

Now, you can close the discussion and rate the answer.

Dr Soumen
Above answer was peer-reviewed by
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