Four cases of fetal sacrococcygeal teratomas were managed in Kuwait Maternity Hospital in the previous 2.5 years, making an incidence of 1 in 10,000 deliveries. Three were diagnosed antenatally and one unbooked case presented during labor with dystocia. Polyhydramnios and characteristic ultrasonic tumor echogenicity were documented. Two patients were delivered vaginally after partial excision of the tumor through hysterotomy. In all cases female infants were delivered. Tumor size dictated the mode of delivery being vaginal in cases with maximum tumor diameter less than 10 cm. A single infant survived after tumor excision done 48 h after delivery. All tumors were histopathologically benign. Routine antenatal ultrasonic examinations should allow early diagnosis of such cases to avoid unanticipated dystocia. In the absence of associated major anomalies amniocentesis may relieve maternal symptoms, when necessary, and postpone onset of premature labor, vaginal delivery should be allowed in cases with maximal tumor diameter less than 10 cm. This should be conducted in a center with experienced neonatal and pediatric surgical care.

This study represents the first of its kind in Kuwait. Two preparations of prostaglandin E2 (PGE2) have been compared as agents for induction of labor. In a randomized controlled study of 200 women of low parity and unfavorable cervical induction features induction of labor by means of a single vaginal tablets of PGE2 was compared with locally prepared PGE2 vaginal pessaries. The gradual increase of uterine contractions and the establishment of labor in a similar way to that observed during spontaneous labor was more apparent after PGE2 tablets. Labor induction was successful in 80% of patients in PGE2 tablet group compared with 59% in PGE2 pessaries group. The incidence of cesarean section was equal in both groups (4%), but none was performed due to uterine hyperactivity. The data presented indicate that the PGE2 vaginal tablet is safe and effective in induction of labor in healthy women at term.