Patient presents with a diagnosis of pregnancy complicated by vaginal cyst.  The patient is currently at [gestational age] weeks gestation confirmed by [method of dating, e.g., LMP, ultrasound].  Chief complaint is [patient's primary concern, e.g., vaginal discomfort, palpable mass, dyspareunia].  Review of systems reveals [list pertinent positives and negatives related to pain, pressure, bleeding, discharge, urinary or bowel symptoms].  Physical examination confirms the presence of a vaginal cyst measuring [size] cm located at [location, e.g., anterior vaginal wall, posterior vaginal wall, Bartholin's gland].  The cyst is [description, e.g., fluctuant, non-tender, mobile, erythematous].  Differential diagnoses considered include Gartner's duct cyst, inclusion cyst, Bartholin's gland cyst, and Skene's duct cyst.  Ultrasound imaging [was/was not] performed and revealed [ultrasound findings if applicable].  Plan of care includes [conservative management, surgical excision, I&D] based on patient symptoms, cyst size, and gestational age.  Risks and benefits of treatment options were discussed with the patient.  Patient education provided regarding vaginal hygiene, pain management, and signs and symptoms of infection.  Follow-up scheduled in [timeframe] to monitor cyst size and symptoms.  ICD-10 code O26.81, other specified disorders of pregnancy, complicated by other conditions, is considered for medical billing and coding purposes.  Medical necessity for procedures and treatments will be documented according to established guidelines.