Sonographic demonstration of fetal sacrococcygeal teratoma

Holzgreve, Wolfgang; Mahony, Barry S.; Glick, Philip L.; Filly, Roy A.; Harrison, Michael R.; deLorimier, Alfred A.; Holzgreve, Alfred; Müller, Klaus; Anderson, Robert L.; Golbus, Mitchell S.

doi:10.1002/pd.1970050402

Cited by 33 publications

(23 citation statements)

References 17 publications

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“…This case report agrees with previous reported cases in which successful management of sacrococcygeal teratomas could be achieved with accurate prenatal sonographic diagnosis, atraumatic delivery, and prompt surgical intervention [2,7,9,17].…”

Section: Discussionsupporting

confidence: 91%

Section: Discussionmentioning

confidence: 99%

“…With the more frequent use of sonography, congenital sacrococcygeal teratomas are increasingly diagnosed antepartum [2,6,7,9,10,14,17]. Once the diagnosis is made, serial sonographic examinations have been advocated [2,9,17]. Sonography allows not only measurements of the tumor, but also its characterization as to whether it is predominantly solid or cystic, its documentation as to growth or changes in the tumor itself during pregnancy, and facilitates interventional procedures such as transabdominal puncture prior to cesarean section [12].…”

Section: Discussionmentioning

confidence: 99%

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Prenatal sonographic diagnosis of congenital sacrococcygeal teratoma and management

Sepúlveda

1989

Jpme

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Section: Discussionsupporting

confidence: 91%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Prenatal sonographic diagnosis of congenital sacrococcygeal teratoma and management

Sepúlveda

1989

Jpme

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“…In a small number of patients the indication for a sonographic scan is the presence of a large-for-date uterus, with a substantial increase in size during the late second or early third trimester. This finding is accounted for by the large size of the tumor and/or the associated polyhydramnion [16,23,36].…”

Section: Diagnosismentioning

confidence: 98%

“…A predominantly cystic SCT must be distinguished from a myelomeningocele. The latter is invariably associated with a spinal dysraphic defect, and careful evaluation of the posterior elements of the lumbosacral spine is required [23,36]. Other masses with a solid or mixed appearance found in the sacrococcygeal area include chordoma, lipoma, rhabdo- Neubert/Trautmann/Tanner/Steiner/Linke/ Bahlmann myosarcoma, hemangioma and malignant melanoma.…”

Section: Differential Diagnosismentioning

confidence: 99%

Sonographic Prognostic Factors in Prenatal Diagnosis of SCT

Neubert¹,

Trautmann²,

Berno³

et al. 2004

Fetal Diagn Ther

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Objective: A subset of fetuses with sacrococcygeal teratomas (SCT) develops hydrops caused by high-output heart failure. Identification of fetuses at risk for hydrops is important because surgical intervention may reverse the pathophysiology of the disease. The aim of this study was to evaluate sonographic prognostic factors regarding tumor morphology and vascularity associated with the development of hydrops in utero. Methods: Over a 10-year period, we identified 7 fetuses with SCT diagnosed antenatally and managed at the University of Mainz. We retrospectively reviewed the charts of mothers and infants and recorded data on prenatal diagnosis, tumor size and localization, perinatal management, neonatal care, and fetal outcome. Results: The diagnosis of SCT was made in all cases by ultrasound. The median gestational age at the time of initial diagnosis was 23 weeks. In 3 cases, signs of fetal heart failure were detected by ultrasound. Pathological blood flow in the venous system was further noted in 2 cases. One fetus developed hydrops. The mean gestational age at delivery was 35 weeks, depending on the presence or absence of maternal or fetal complications. Six infants were delivered by cesarean section, and 1 by vaginal delivery. After fetal stabilization, surgery was performed in 5 of 7 cases. Inadequate ventilation secondary to prematurity was a contributing factor to death in 1 fetus. One fetal intrauterine death occurred at 27 weeks of gestation. Conclusion: Pregnancies with antenatally diagnosed fetal SCT necessitate frequent monitoring to ensure the detection of fetal/maternal complications by ultrasound and Doppler ultrasound. The most important prognostic criteria were cardiomegaly, fetal hydrops, and increased preload indexes of the fetal venous system as sign of fetal heart failure. Many studies show that the occurrence of pulsations in the umbilical vein of a hydropic fetus correlates with a poor fetal outcome. The decision on the optimal time of delivery should therefore be made by a multidisciplinary team of specialists.

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Maternal Outcome After Open Fetal Surgery

Longaker

Golbus²,

Filly³

et al. 1991

JAMA

120

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A few fetal diseases may benefit from surgical treatment before birth, but hysterotomy and subsequent delivery by cesarean section pose a risk to the otherwise unaffected mother. To assess maternal risk of mortality, morbidity, and reproductive potential after fetal surgery, we reviewed our experience with 17 highly selected women who underwent fetal surgery. Fifteen of these procedures were performed for one of two congenital anomalies: severe bilateral hydronephrosis and congenital diaphragmatic hernia. There were no deaths or serious maternal injuries. In the 14 women who continued pregnancy after hysterotomy, uterine irritability and preterm labor were frequent complications, requiring early confinement in most cases. There has been no detectable effect on future fertility, as indicated by eight subsequent normal pregnancies. We conclude that hysterotomy for fetal surgery can be accomplished without unduly endangering the mother's life or her future reproductive potential. However, morbidity related to premature labor remains a serious problem, and our ability to control uterine contractions after hysterotomy remains the limiting factor in human fetal surgery.

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Sonographic demonstration of fetal sacrococcygeal teratoma

Cited by 33 publications

References 17 publications

Prenatal sonographic diagnosis of congenital sacrococcygeal teratoma and management

Prenatal sonographic diagnosis of congenital sacrococcygeal teratoma and management

Sonographic Prognostic Factors in Prenatal Diagnosis of SCT

Maternal Outcome After Open Fetal Surgery

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