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Trends and outcomes of ruptured ovarian cysts
  1. Wei How Lim1,2,
  2. Nikki Woods3,
  3. Vincent P Lamaro1,2
  1. 1Gynaecology, St Vincent's Hospital Sydney, Darlinghurst, New South Wales, Australia
  2. 2Gynaecological Surgery, St Vincent’s Institute for Minimally Invasive Surgery, Darlinghurst, New South Wales, Australia
  3. 3Emergency Medicine, St Vincent's Hospital Sydney, Darlinghurst, New South Wales, Australia
  1. Correspondence to Dr Wei How Lim, Gynaecology, St Vincent's Hospital Sydney, Darlinghurst, New South Wales, Australia; weihowlim{at}gmail.com

Abstract

Background Ruptured ovarian cysts are common gynaecological presentation to health institutions with abdominal pain. While this phenomenon is generally self-limiting, surgery may be necessary in cases of haemodynamic compromise or association with torsion. The aim of this audit is to identify the trend of hospital presentations, as well as the review the management of modern gynaecology practice.

Methods A retrospective audit of all women who presented to the emergency department with an imaging diagnosis of ruptured ovarian cysts was conducted over a 5-year period at St Vincent’s Hospital, Sydney.

Results During the study period, 408 women were identified. There was a trend towards conservative management, as observed in 84.7% of women, while the remaining 15.4% underwent surgery. Haemorrhagic or ruptured corpus luteum was the most common diagnoses. As expected, women who had surgical intervention were more likely to have larger cysts (20 vs 50%; p<0.05), and larger free fluid findings on imaging (1.4 vs 23.8%; p<0.05) compared with those managed conservatively. There were no statistically significant differences in location of ovarian cysts (right or left) or antecedent to hospital presentation (vaginal intercourse or trauma).

Conclusion Ruptured ovarian cysts of both functional and non-functional types remained a common clinical presentation of acute pain for women to the emergency department. Majority of women were managed conservatively in our cohort, and indications for surgery were large ovarian cysts and large free fluid seen on imaging findings. Surgery was largely feasible with minimal complications.

  • minimally invasive surgery
  • community gynaecology
  • clinical audit
  • quality in health care

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Footnotes

  • Contributors WHL contributed to the conception and design of the study. WHL and NW were involved in data collection, interpretation of the results, statistical analysis, draft and editing of manuscript. VPL provided supervision, and participated in the interpretation of results. All authors read and approved the final manuscript.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Ethics approval Ethics approval was obtained for the study from the St Vincent’s Hospital Human Research Ethics Committee (Reference 2018/ETH00540).

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data availability statement All data relevant to the study are included in the article or uploaded as onlone supplemental information. All data relevant to the study are reported in the manuscript, which are included in the article or uploaded as supplemental information.

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