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The establishment of ultrasonography in daily gynaecological and obstetric practice has increased the rate of diagnosis of ovarian cysts amongst pregnant women. Both assessment and management of ovarian cysts in pregnancy can be challenging. Although most cysts are functional in nature and a conservative approach can be employed, a small proportion will carry some malignant potential. Identifying which cysts can be safely managed expectantly and which necessitate surgical intervention, investigating possible cyst accidents, deciding on the timing and nature of intervention (fine needle aspiration versus cystectomy or even oophorectomy), the surgical approach (laparotomy versus laparoscopy) and balancing the risks and benefits for the mother and the fetus are just a few examples of the dilemmas that need to be addressed, ideally within a multidisciplinary team-based environment.
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