Ovarian Cysts in Pregnancy: Are They a Problem?

It's common for women of childbearing age to get ovarian cysts, and it's not unusual for moms-to-be to find out they have one while they're pregnant.

Fortunately, the vast majority of ovarian cysts are harmless and don't cause issues in pregnancy. Here's what you need to know about ovarian cysts during pregnancy.

Key Takeaways

• Ovarian cysts during pregnancy are common — and usually harmless. Many women develop ovarian cysts as part of their normal cycle, and sometimes they're discovered during early pregnancy ultrasounds. Most cysts don't cause problems and often go away on their own.
• Most pregnancy-related cysts resolve on their own. One common type of cyst forms after ovulation and actually helps support early pregnancy hormones. In most cases, it shrinks and disappears by the second trimester without treatment.
• Your provider will keep an eye on it. If a cyst shows up on an ultrasound, your doctor will usually monitor it to make sure it isn't growing or causing symptoms. Surgery is rarely needed, and most cysts don't affect your pregnancy or your baby at all.

What is an ovarian cyst?

An ovarian cyst is a fluid-filled sac located within the ovary. Many women have ovarian cysts at some point in their lives. Most are harmless, don't cause pain, and resolve on their own after four to six weeks.

The two most common types of ovarian cysts are called functional cysts and include:

• Follicular cysts. Follicular cysts form when an ovarian follicle (the tiny sac where the egg grows) doesn't release the egg as it should during ovulation and instead continues to grow and fill with fluid.
• Corpus luteum cysts. A corpus luteum develops after an egg is released from a follicle during ovulation. The follicle sac then shrinks into cells that produce hormones to support the rest of the menstrual cycle, or, in the case of a pregnancy, the growing baby. If fluid collects in the empty follicle and the sac doesn't shrink, however, a cyst can form.

"I regularly get them as part of my monthly cycle," says What to Expect Community mom kmm083. "I suspect I had one this pregnancy, too, but it was just a little crampy and went away in the first few weeks."

Other, less common, types of ovarian cysts are called pathological cysts and include:

• Dermoid cysts. Also called teratomas, these cysts are made up of ovarian germ cells and can contain teeth, hair, skin, or fat. They're present from birth but often aren't discovered until later in life.
• Endometriomas. Also called "chocolate cysts," these occur in women who have endometriosis. The cysts are filled with endometriotic fluid or blood, so they can appear darker in color. They may be painful.
• Cystadenomas cysts. These cysts can develop on the surface of the ovary and tend to be large and solid.

What causes an ovarian cyst during pregnancy?

During pregnancy, the corpus luteum produces hormones that nourish and support the uterine lining and the growing baby until the placenta takes over at around 10 weeks. But in a small number of pregnancies, the corpus luteum fills with fluid and remains on the ovary instead of shrinking. This is called a corpus luteum cyst.

Track your symptoms in the What to Expect app — and see what your body is telling you.

Sometimes, ultrasounds reveal another type of ovarian cyst that you had before you became pregnant.

"I get cysts a lot outside of pregnancy," says Community mom mamasquill. "I had a cyst on one ovary during pregnancy, and everything was okay. It was a little uncomfortable, a little cramping. I didn't even think much of it until my next ultrasound confirmed it."

What should I do if I have an ovarian cyst during pregnancy?

Most ovarian cysts won't affect your pregnancy at all. For instance, when it comes to a corpus luteum cyst, chances are it will go away on its own by the second trimester.

"I had them with both of my previous pregnancies and just saw one on my right ovary this pregnancy. Both times they resolved before the second trimester," says Community mom bears1616.

Other types of cysts can continue to grow during pregnancy, and, in some cases, may cause pain. Even then, they usually don't cause problems for the pregnancy.

To be sure that an ovarian cyst doesn't impact your pregnancy and to monitor any existing cysts, your doctor will schedule regular ultrasounds to monitor your ovaries. An ovarian cyst ultrasound will track the size and condition of any cyst to make sure it isn't growing or changing in a concerning way.

"I was traumatized at my 8-week appointment because they found a cyst in my ovary. Of course my mind went to worst-case scenarios," says Community member OctStein2022. But at a 12-week ultrasound to check on it, she says, "It had actually gotten smaller — and at my 19-week appointment it was gone."

Ovarian cyst symptoms

Most cysts don't cause symptoms, but some ovarian cysts can cause:

• Pain. Pain can occur in the lower abdomen or pelvic area on the side the cyst is located. It maybe sharp or dull, and it can feel like a twinge or come and go. If an ovarian cyst ruptures, the pain may be moderate or sudden and severe. In rare cases, an ovarian cyst can cause the ovary to twist (called ovarian torsion), which can be extremely painful and require emergency surgery.
• Bloating.
• Abdominal fullness or pressure.

"Sometimes if the baby is pushing against them I get a dull pain, but other than that they are not doing any damage to me or my little guy," says Community mom 86butterfly about her cysts.

Keep track of your appointments and symptoms in the My Journal section of the What to Expect app, where you can also get expert advice and connect with other moms-to-be who have ovarian cysts.

Ovarian cyst treatments

Most ovarian cysts disappear on their own and don't require treatment. In rarer cases, such as when a cyst ruptures or causes ovarian torsion, the following treatments may be recommended:

• Rest.
• Pain medication, though check with your doctor first about what's safe to take during pregnancy.
• Surgery. If surgery is necessary during pregnancy, your doctor will make every effort to perform it laparoscopically (through small incisions in the abdomen). If the cyst is very large, laparoscopic surgery may not be possible, and you may need open abdominal surgery (laparotomy).

"I had a large ovarian cyst removed surgically after I delivered my first baby," says Community mom slupo1023. "The ovarian cyst was detected when I was 8 weeks pregnant and then I had surgery at 9 weeks postpartum. Part of my ovary was removed as well. I was able to successfully get pregnant a year after my surgery."

What if my ovarian cyst bursts during pregnancy?

Usually, a ruptured ovarian cyst, even during pregnancy, isn’t cause for alarm. The fluid from the cyst reabsorbs on its own with time, and all that's needed is some medication to manage any discomfort and pelvic rest for a few days.

In fact, most doctors recommend watchful waiting (observation and monitoring with ultrasounds) as the preferred approach for ruptured ovarian cysts during pregnancy.

However, your doctor may recommend surgery if there is:

• A risk of an infection due to the rupture
• Significant bleeding
• Torsion
• Another complication affecting the pregnancy

Burst ovarian cyst symptoms

Not all women feel pain after a ruptured ovarian cyst, but some do experience symptoms when the rupture occurs. These may include:

• Moderate to severe pain. The pain can be sharp and sudden and may occur in the lower abdomen or even the back.
• Vaginal bleeding or spotting.
• Nausea or vomiting (in the case of a torsion).
• Dizziness.
• Fever.

Do ovarian cysts during pregnancy disappear?

Corpus luteum cysts usually disappear on their own by the second trimester. And, again, most ovarian cysts during pregnancy are harmless.

Still, if you're experiencing pain or any other symptoms, let your practitioner know. Careful monitoring and treatment if needed can help keep both you and your baby safe.