Predicting the intrauterine fetal death of fetuses with cystic hygroma in early pregnancy

Abstract

We investigated whether it was possible to predict the prognosis of fetuses with cystic hygroma in early pregnancy based on the degree of neck thickening. We retrospectively analyzed 57 singleton pregnancies with fetuses with cystic hygroma who were examined before the 22nd week of pregnancy. The fetuses were categorized according to the outcome, structural abnormalities at birth, and chromosomal abnormalities. Here, we proposed a new sonographic predictor with which we assessed neck thickening by dividing the width of the neck thickening by the biparietal diameter, which is expressed as the cystic hygroma width/biparietal diameter ratio. The median cystic hygroma width/biparietal diameter ratio in the intrauterine fetal death group (0.51) was significantly higher than that in the live birth group (0.27). No significant difference in the median cystic hygroma width/biparietal diameter ratio was found between the structural abnormalities group at birth and the no structural abnormalities group, and no significant difference in the median cystic hygroma width/biparietal diameter ratio was found between the chromosomal abnormality group and the no chromosomal abnormality group. We used receiver operating characteristic analysis to evaluate the cystic hygroma width/biparietal diameter ratio to predict intrauterine fetal death. When the cystic hygroma width/biparietal diameter ratio cut-off value was 0.5, intrauterine fetal death could be predicted with a sensitivity of 52.9% and a specificity of 100%. It is possible to predict intrauterine fetal death in fetuses with cystic hygroma in early pregnancy if cystic hygroma width/biparietal diameter ratio is measured. However, even if cystic hygroma width/biparietal diameter ratio is measured, predicting the presence or absence of a structural abnormality at birth or a chromosomal abnormality is difficult.

Role of prenatal imaging in the diagnosis and management of fetal facio-cervical masses

“…Congenital conditions of facial and cervical structures that are associated with fetal growth, genetic diseases, fetal death, and upper airway obstruction, are associated with significant morbidity and may even be fatal 16,17 . Rapid advances in imaging and instrumentation technology combined with superior knowledge of fetal pathophysiology, have led to the development of novel intrapartum interventions for most common fetal anomalies [18][19][20] .…”

Obstetric Outcomes in the Surviving Fetus after Intrauterine Fetal Death in Bichorionic Twin Gestations

“…It is important to note that IUFD has a multifactorial etiology, not only with fetal genetic disorders and congenital malformations but also maternal infections and placental/umbilical cord complications [13][14][15]. The literature related to preventing it is usually controlling factors prior to conception, such as avoiding unhealthy habits (alcohol, tobacco, and illegal drugs consumption) and maintaining genital hygiene to prevent infections, and during pregnancy, as well as regular obstetrical controls to screen abnormal fetal malformation and pregnancy complications (i.e., gestational diabetes, gestational hypertension and preeclampsia), controlling pregnancy in advanced maternal age (maternal age ≥ 35 years), and increasing appropriate healthy habits with a balanced diet and physical activity [16][17][18], particularly in twin pregnancies.…”

Higroma quístico fetal

“…En 2010, la conducta era observación de la evolución del caso 17 y que aun en presencia de signos ecográfico prenatales severos, no se podía comunicar de un mal pronóstico a los padres. En la actualidad, Shimura y col 18 realiza el uso del RBC (medición ecográfica del ancho del higroma quístico implica vistas horizontales del diámetro biparietal, método de medición de la relación de ancho de higroma quístico (CH)/ diámetro biparietal) que permite proporcionar a las familias, información que puede ayudarles en su decisión de continuar el embarazo. De la misma forma puede ser aplicable para siguientes casos a presentarse.…”