Prenatal Diagnosis and Perinatal Management of Fetal Sacrococcygeal Teratoma

Christian A. Chisholm; Angela L. Heider; Jeffrey A. Kuller; Daniel von Allmen; Michael J. McMahon; Nancy C. Chescheir

doi:10.1055/s-2007-993835

American Journal of Perinatology, Table of Contents

Am J Perinatol 1999; 16(1): 47-50
DOI: 10.1055/s-2007-993835

ORIGINAL ARTICLE

Prenatal Diagnosis and Perinatal Management of Fetal Sacrococcygeal Teratoma

Christian A. Chisholm¹ , Angela L. Heider¹ , Jeffrey A. Kuller¹ , Daniel von Allmen² , Michael J. McMahon¹ , Nancy C. Chescheir¹

¹Division of Maternal-Fetal Medicine, Departments of Obstetrics and Gynecology and Surgery, University of North Carolina School of Medicine, Chapel Hill, North Carolina
²Division of Pediatric Surgery, Departments of Obstetrics and Gynecology and Surgery, University of North Carolina School of Medicine, Chapel Hill, North Carolina

Abstract

ABSTRACT

Sacrococcygeal teratoma is the most common fetal neoplasm, with an incidence of 1 in 40,000 births. Fetuses with this malformation are at risk for significant perinatal morbidity and mortality. We identified nine fetuses with sacrococcygeal teratomas that were diagnosed antenatally and managed at the University of North Carolina Hospitals over a 7-year period. We retrospectively reviewed the charts of mothers and infants and recorded data concerning perinatal and surgical management. Six infants survived the neonatal period. All infants diagnosed after 20 weeks' gestation survived. Fetal hydrops developed in three fetuses, all of whom died. Inadequate ventilation secondary to prematurity was a contributing factor in each lethal case. Diagnosis at an early gestational age, development of fetal hydrops, and premature delivery predicted a poor prognosis. When possible, we recommend that delivery be delayed to allow for fetal development. Stabilization of the infant should be attempted before resection of the teratoma.

Keywords

Fetal sacrococcygeal teratoma - prenatal diagnosis - hydrops fetalis

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