Prenatal Resection of a Fetal Pericardial Teratoma

Sydorak, Roman M.; Kelly, Thomas F.; Feldstein, Vickie A.; Sandberg, Per; Silverman, Norman H.; Harrison, Michael R.; Albanese, Craig T.

doi:10.1159/000063180

Cited by 46 publications

(41 citation statements)

References 22 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…In comparison to others, teratoma occurs not in the heart, but with close contact with aorta or pulmonary artery 11,12 . Fetuses with teratoma are presenting various clinical symptoms, from asymptomatic, to mild pericadial effusion up to hydrops fetalis.…”

Section: Hydrops Testiscontrasting

confidence: 68%

See 1 more Smart Citation

Single Fetal Cardiac Tumors and Follow-Up Based on 13 Cases from the Fetal Cardiac Referral Center in 1993-2017

Żalińska

Korabiewska

Krekora

et al. 2017

Prenatal Cardiology

View full text Add to dashboard Cite

Single fetal cardiac tumors and follow-up based on 13 cases from the Fetal Cardiac Referral Center in Prenat Cardio 2017 Jan; 7(1):43-49 DOI: 10.1515/pcard-2017-0007 INTRODUCTIONFetal cardiac tumors are rare anomalies: 0,08-0,2% 1,2, while data from Polish Nationwide Register of Fetal Cardiological Problems (in polish-ORPKP), suggested higher prevalence (1,05% Single fetal cardiac tumors are some sort of enigma and for now, there is no unitary algorythm of proceeding, that is why it become the aim of our work. MATERIALThe analysis included 13 cases from our unit Fetal Cardiology Department -Referral Center in the middle of Poland, during the years 1993-2017. Study group were women at the age of 18-37 years, average gestational age during targeted echocardiography examination was 34 weeks of pregnancy. The earliest registration of cardiac tumor was in 20th week of pregnancy, and the latest was during perinatal period (40th week of pregnancy).Corresponding author : a.b.zalinska@gmail.com Submitted: 2017-11-16; accepted: 2017-11-25 Results: Ten out of 13 fetuses with single cardiac tumors (SFCT) had cardiomegaly: on average HA/CA was 0,49. The size of the tumor was different: the smallest one -6 x 6 mm, the biggest 47 x 47 mm. The way of the delivery: in 10 cases there was CS and in 3 cases natural delivery. Birth weight was from 2000-3950 g (average 2989,2 g). Cardiosurgical resection of the tumor was performed on 4 newborns: at 2nd, 4th, 8th and 16th day of life (average 7,5 day). Four neonatal deaths were registered (31%): in 1st 2nd and 11th day (before surgery) and in the 28th day after the operation.Conclusions: Single fetal cardiac tumors (SFCT) can be diagnosed at 20 weeks of pregnancy, which allows to start echocardiographic monitoring, taking into consideration the potential risk of hemodynamic progression. SFCT can be the first sign of tuberous sclerosis complex in later prenatal or postnatal life. SFCT other than rhabdomyoma can be asymptomatic in newborn, but may require an early cardiosurgical resection.

show abstract

Section: Hydrops Testiscontrasting

confidence: 68%

“…Yinon et al reported about 40 cases of fetuses with teratoma and none of them survived 13 . Sydorak et al described 31 year old patient, at 24 weeks of pregnancy with teratoma and in this case hydrops fetalis occured 11 .…”

Section: Hydrops Testismentioning

confidence: 70%

Single Fetal Cardiac Tumors and Follow-Up Based on 13 Cases from the Fetal Cardiac Referral Center in 1993-2017

Żalińska

Korabiewska

Krekora

et al. 2017

Prenatal Cardiology

View full text Add to dashboard Cite

show abstract

“…531,532 Open fetal surgery for extracardiac conditions affecting the heart such as resection of pericardial teratoma is possible. 533,534 Innovative open fetal surgical procedures that may be lifesaving to the fetus or may improve postnatal outcomes may be pursued on an investigational basis, but only once the benefits are carefully weighed against the risks to both fetus and mother.…”

mentioning

confidence: 99%

Diagnosis and Treatment of Fetal Cardiac Disease

Donofrio¹,

Moon-Grady²,

Hornberger³

et al. 2014

Circulation

Self Cite

973

543

View full text Add to dashboard Cite

Background— The goal of this statement is to review available literature and to put forth a scientific statement on the current practice of fetal cardiac medicine, including the diagnosis and management of fetal cardiovascular disease. Methods and Results— A writing group appointed by the American Heart Association reviewed the available literature pertaining to topics relevant to fetal cardiac medicine, including the diagnosis of congenital heart disease and arrhythmias, assessment of cardiac function and the cardiovascular system, and available treatment options. The American College of Cardiology/American Heart Association classification of recommendations and level of evidence for practice guidelines were applied to the current practice of fetal cardiac medicine. Recommendations relating to the specifics of fetal diagnosis, including the timing of referral for study, indications for referral, and experience suggested for performance and interpretation of studies, are presented. The components of a fetal echocardiogram are described in detail, including descriptions of the assessment of cardiac anatomy, cardiac function, and rhythm. Complementary modalities for fetal cardiac assessment are reviewed, including the use of advanced ultrasound techniques, fetal magnetic resonance imaging, and fetal magnetocardiography and electrocardiography for rhythm assessment. Models for parental counseling and a discussion of parental stress and depression assessments are reviewed. Available fetal therapies, including medical management for arrhythmias or heart failure and closed or open intervention for diseases affecting the cardiovascular system such as twin–twin transfusion syndrome, lung masses, and vascular tumors, are highlighted. Catheter-based intervention strategies to prevent the progression of disease in utero are also discussed. Recommendations for delivery planning strategies for fetuses with congenital heart disease including models based on classification of disease severity and delivery room treatment will be highlighted. Outcome assessment is reviewed to show the benefit of prenatal diagnosis and management as they affect outcome for babies with congenital heart disease. Conclusions— Fetal cardiac medicine has evolved considerably over the past 2 decades, predominantly in response to advances in imaging technology and innovations in therapies. The diagnosis of cardiac disease in the fetus is mostly made with ultrasound; however, new technologies, including 3- and 4-dimensional echocardiography, magnetic resonance imaging, and fetal electrocardiography and magnetocardiography, are available. Medical and interventional treatments for select diseases and strategies for delivery room care enable stabilization of high-risk fetuses and contribute to improved outcomes. This statement highlights what is currently known and recommended on the basis of evidence and experience in the rapidly advancing and highly specialized field of fetal cardiac care.

show abstract

“…Van Selm et al [20] reported one eclamptic seizure and three cases of fetal demise despite intrauterine transfusions for immune hydrops. In an additional case of fetal cardiac compromise with pericardial teratoma fetal hydrops persisted despite in utero resection [21] . Over the course of 3 weeks evolving mirror syndrome led to an emergency cesarean section.…”

Section: Discussionmentioning

confidence: 92%

Maternal Mirror Syndrome after in utero Aortic Valve Dilation

Mizrahi‐Arnaud

Haug²,

Marshall³

et al. 2006

Fetal Diagn Ther

View full text Add to dashboard Cite

Fetal hydrops of various etiologies can be associated with maternal mirror syndrome. The exact pathophysiology of this rare disorder remains unclear, yet it can result in significant maternal and fetal morbidity. The recent advances in prenatal diagnosis and therapeutic interventions have focused on altering the course of pathologies associated with an expected poor prognosis. Severe fetal aortic valve stenosis with its potential for hypoplastic left heart fit this category. We report a case of maternal mirror syndrome in a parturient following intrauterine therapy for severe fetal aortic stenosis and hydrops. Despite a technically successful intervention, the mother required emergency cesarean section. We review the few reports of mirror syndrome as well as the current approaches to fetal aortic stenosis. This case reinforces the need for in depth risk analysis prior to fetal interventions. It also emphasizes the advantage of earlier detection and therapy with fetal aortic stenosis since fetal hydrops carries a somber prognosis.

show abstract

Prenatal Resection of a Fetal Pericardial Teratoma

Cited by 46 publications

References 22 publications

Single Fetal Cardiac Tumors and Follow-Up Based on 13 Cases from the Fetal Cardiac Referral Center in 1993-2017

Single Fetal Cardiac Tumors and Follow-Up Based on 13 Cases from the Fetal Cardiac Referral Center in 1993-2017

Diagnosis and Treatment of Fetal Cardiac Disease

Maternal Mirror Syndrome after in utero Aortic Valve Dilation

Contact Info

Product

Resources

About