Perinatal outcome of sacrococcygeal teratoma

Lee, Mi-Young; Won, Hye‐Sung; Hyun, Myung-Soo; Lee, Heeyoung; Shim, Jae-Yoon; Lee, Pil-Ryang

doi:10.1002/pd.2865

Cited by 42 publications

(30 citation statements)

References 19 publications

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“…Similarly, sacrococcygeal teratoma or arteriovenous malformations, characterized by high blood flow through the tumor (volume overload), can also lead to heart failure [123,124]. The inferior vena cava and the cardiac ventricles dilate due to increased venous return from the tumor, even though these fetuses typically maintain a normal shortening fraction as intrinsic contractility is not affected until the final stages.…”

Section: Research and Clinical Applications Of Fetal Cardiac Functionmentioning

confidence: 99%

“…Similarly, a dilated superior vena cava and cardiomegaly develop in deteriorating fetuses with large cerebral arteriovenous malformations such as an aneurism of the vein of Galen. In both conditions, neonatal outcomes are poorer in fetuses that develop hydrops prior to delivery, and recognition of more subtle signs of cardiac failure may prompt antenatal intervention or delivery [123,124]. …”

Section: Research and Clinical Applications Of Fetal Cardiac Functionmentioning

confidence: 99%

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Fetal Cardiac Function: Technical Considerations and Potential Research and Clinical Applications

2012

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Fetal echocardiography was initially used to detect structural anomalies but has more recently also been proposed to assess fetal cardiac function. This review summarizes technical issues and limitations in fetal cardiac function evaluation, as well as its potential research and clinical applications. Functional echocardiography has been demonstrated to select high-risk populations and to be associated with outcome in several fetal conditions including intrauterine growth restriction, twin-to-twin transfusion syndrome, maternal diabetes, and congenital diaphragmatic hernia. Fetal heart evaluation is challenging due to the smallness and high heart rate of the fetus and restricted access to the fetus far from the transducer. Due to these limitations and differences in cardiac function which are related to fetal maturation, cardiovascular parameters should be validated in the fetus and used with caution. Despite these precautions, in expert hands and with appropriate ultrasound equipment, evaluation of cardiac function is feasible in most fetuses. Functional fetal echocardiography is a promising tool that may soon be incorporated into clinical practice. Research is warranted to further refine the contribution of fetal cardiac assessment to the diagnosis, monitoring, or prediction of outcomes in various fetal conditions.

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Section: Research and Clinical Applications Of Fetal Cardiac Functionmentioning

confidence: 99%

Section: Research and Clinical Applications Of Fetal Cardiac Functionmentioning

confidence: 99%

Fetal Cardiac Function: Technical Considerations and Potential Research and Clinical Applications

2012

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“…The outcome of the other 2 cases is not reported [42]. Other known fetal interventions are cyst aspiration, amnioreduction, amnioinfusion, open fetal surgical resection [43], radiofrequency ablation or tumor or abdomino-amniotic shunt [44]. …”

Section: Indications For Iutmentioning

confidence: 99%

Intrauterine Blood Transfusion: Current Indications and Associated Risks

Lindenburg

Kamp

Oepkes³

2014

Fetal Diagn Ther

137

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Fetal anemia is a serious complication in pregnancy and associated with perinatal mortality and morbidity. During 25 years of worldwide experience with intravascular intrauterine blood transfusion, a variety of indications have been described. Intrauterine transfusion (IUT) treatment is considered most successful for fetal anemia due to red cell alloimmunization. Moreover, the use of this procedure has also been reported in pregnancies with parvovirus B19 infection, fetomaternal hemorrhage and placental chorioangiomas, for example. This review focuses on the current indications of intrauterine blood transfusions. In addition, we describe the potential complications of IUT treatment.

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“…Delaying delivery permits fetal hydrops to worsen with irreversible neonatal sequelae, and leaving the tumor growth unchecked increases the likelihood of intratumoral hemorrhage or intra-amniotic tumor rupture and fetal exsanguination [7]. Many now agree it may be preferable to deliver a more premature infant in a less compromised hydropic state, than to deliver a full-term infant in cardiovascular failure [7,19]. With continuing advances in neonatal care, postnatal survival without severe neurologic and pulmonary sequelae is becoming a real possibility for the extremely premature infant [14] and we have shown an acceptable morbidity of prematu- rity in this series.…”

Section: Discussionmentioning

confidence: 99%

Preemptive Delivery and Immediate Resection for Fetuses with High-Risk Sacrococcygeal Teratomas

Baumgarten¹,

Gebb²,

Khalek³

et al. 2018

Fetal Diagn Ther

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Introduction: Fetuses with “high-risk” sacrococcygeal teratoma (SCT) have a mortality rate of 40–50%. While fetal surgery may benefit select fetuses prior to 27 weeks’ gestation, many fetuses die due to consequences of rapid tumor growth after 27 weeks. Here we report our experience applying “preemptive” delivery to fetuses who manifest signs of decompensation between 27 and 32 weeks. Methods: A retrospective review of SCT fetuses delivered between 2010 and 2016 at ≤32 weeks’ gestation was performed. Patients who decompensated prior to 27 weeks and were treated with fetal surgery or neonatal palliation were excluded. Results: Forty-two SCT fetuses were evaluated, and 11 were preemptively delivered in response to impending fetal or maternal decompensation. Nine (81.8%) survived. One death was due to pulmonary hypoplasia in a neonate with significant intra-abdominal tumor burden, and the other was due to in utero tumor rupture. There were no deaths related to prematurity in this cohort. Conclusions: Many fetuses with SCT manifest signs of decompensation between 27 and 32 weeks. In the absence of fetal hydrops prior to 27 weeks or tumor rupture in utero, early delivery is associated with favorable outcomes. Our single-center experience supports a management algorithm change to incorporate “preemptive” delivery for selected cases.

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Perinatal outcome of sacrococcygeal teratoma

Abstract: Fetuses with SCT undergoing in utero intervention have worse prognostic features, yet their neonatal outcome is similar to those of fetuses not requiring intervention.

Cited by 42 publications

References 19 publications

Fetal Cardiac Function: Technical Considerations and Potential Research and Clinical Applications

Fetal Cardiac Function: Technical Considerations and Potential Research and Clinical Applications

Intrauterine Blood Transfusion: Current Indications and Associated Risks

Preemptive Delivery and Immediate Resection for Fetuses with High-Risk Sacrococcygeal Teratomas

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