Background: Sacrococcygeal teratoma is one of the most frequently prenatally diagnosed neoplasias. Obstetric ultrasound has a role in the diagnosis and management of these tumors during pregnancy. In this report, we describe a multidisciplinary approach in a case of a patient with sacrococcygeal teratomas and preterm delivery, as well as postnatal outcomes. Case presentation: A 26-year-old Caucasian woman at 20.3 weeks of gestation with a normal gestational course and no relevant medical or surgical history was referred to our institution with a sacrococcygeal mass diagnosis. Magnetic resonance imaging confirmed the diagnosis of sacrococcygeal teratoma type I according to the Altman classification. Follow-up with ultrasound showed an increase in the size of the mass up to 190 × 150 mm, high Doppler flow, and severe polyhydramnios. At 35.1 weeks of gestation, the patient had premature rupture of membranes, and an emergency cesarean section was performed due to recurrent late decelerations detected by fetal heart rate monitoring. Afterward, surgery was performed successfully at 36 hours of life. Posterior controls revealed normal and healthy child growth. Conclusions: This case report demonstrates the importance of a multidisciplinary approach to offer the best neonatal outcomes by performing early surgery, as well as the need for follow-up by ultrasound in order to minimize complications by assessing mass growth, Doppler flow, and amniotic fluid.

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Objective: The aim of this study was to investigate the role of the 'angle of progression' (AOP) in the prediction of vaginal delivery and establish a cut-off value.Method: 101 pregnant women were included in this prospective study. They were admitted in labor to our hospital and had singleton cephalic presentations and full-term pregnancies. AOP was measured at admission time. We analyzed the results of all the women included but also a subgroup of 66 singleton pregnant women whose assessment of the AOP was performed at the beginning of the second stage of labor.Results: Ninety-one patients had a vaginal delivery (90%) and 19 a cesarean section (10%).The area under the curve was 0.85 (95% confidence interval [CI], 0.77-0.92)and the value of the AOP that optimizes the curve was 125º (S 67.1% E 100%). In the subgroup that was assessed at the second stage of labor, the area under the curve was 0.97 (95%CI,0.90-0.99) and a value of the AOP that optimizes the curve was also 125º (S 91.38% E 100%). Conclusions:The angle of progression is a simple and reliable intrapartum ultrasound parameter for the evaluation of fetal head descent. Transperineal ultrasound assessment could help to decide the method of delivery. In our experience, the sensitivity of the ultrasound measurement increases when this is taken in the second stage of childbirth.

Background: Multiple factors have been associated with an increased risk of fetal growth restriction. The risk of genetic syndromes in these cases is not well established. The aim of this study was to determine the relationship between chromosomal abnormalities and early fetal growth restriction and to assess the incremental yield of genomic microarray over conventional karyotyping in fetuses with early growth restriction.Methods: A prospective observational study of early fetal growth restriction diagnosed between 2013 and 2016 in our hospital. Chromosomal microarray analysis was performed in fetuses with early growth restriction defined as a fetal weight below the 3rd percentile estimated from 19 to 28 weeks of gestation, and a normal conventional karyotype result. We performed a descriptive analysis of the mean, the interval and the standard deviation for continuous variables and an analysis of absolute frequency and percentages for the categorical variables.Results: Among 28 enrolled pregnant women, the incidence of early fetal growth restriction was 0.30%. We diagnosed 18.5 % of pathological results by arrays, but only one case (3.7%) were diagnosed by conventional karyotype too. Incremental yield of chromosomal microarray analysis over karyotyping was 16%. We detected a 20% incremental yield of chromosomal microarray analysis over karyotyping in fetus with structural anomalies, and a 17.6% incremental yield in isolated early fetal growth restriction. Conclusions:The use of chromosomal microarray analysis provided a 16% incremental yield of detecting copy number variations in fetuses with early growth restriction and normal karyotype. Prenatal array should be part of the usual study of these fetuses, especially if there have ultrasound malformations associated.

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