Traumatic rupture of dermoid cyst in early pregnancy: diagnosis and management in Peki Government Hospital resulting in a successful delivery at term

Abstract

Introduction: Dermoid cyst is the commonest germ cell tumour, constituting about 20% of adult ovarian tumours. They are mostly  asymptomatic, but complications such as torsion, rupture, and malignant transformation have been reported. Only a few cases of ruptured mature cystic teratoma in early pregnancy have been described and even fewer are those in early pregnancy with the  pregnancy successfully carried to term with successful delivery.

Case Presentation: We present a case of a grand multiparous woman  who presented to Peki Government Hospital at 11 weeks gestation with an acute abdomen following a fall. She had been diagnosed with  a dermoid cyst a week with dimensions of 20cm x15 cm before the presentation. Ultrasound diagnosis of a possible rupture of the cyst  was made on admission. Right oophorectomy was done at laparotomy. She had progesterone support for the succeeding 4 weeks and  the pregnancy was successfully carried to term with good outcomes at delivery for both mother and baby. The APGAR score for the baby  at 1minute and 5minute after birth were 7/10 and 8/10 respectively.

Conclusion: Traumatic rupture of dermoid cyst should be considered  as a differential diagnosis in women presenting with acute abdomen in early pregnancy. Laparotomy with abdominal lavage  is a viable management option in a low-resource setting.