Spontaneous rupture of sacrococcygeal teratoma associated with acute fetal anemia

Yamaguchi, Yoshiyuki; Tsukimori, Kiyomi; Hojo, Satoshi; Nakanami, Naoyuki; Nozaki, Masahiro; Masumoto, Kouji; Taguchi, Tomoaki; Wake, Norio

doi:10.1002/uog.3821

Cited by 21 publications

(23 citation statements)

References 11 publications

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“…Baschat and associates have detected increased MCAPSV in a case of severe acute FMH, confirmed by the Kleihauer-Betke test (19). In a later study, Yamaguchi and associates demonstrated increased PSV of MCA in an actively bleeding fetus due to spontaneous rupture of a sacrococcygeal teratoma (20). To the best of our knowledge, no study has previously investigated the effect of transplacental bleeding on MCAPSV.…”

Section: Discussionmentioning

confidence: 86%

Does bleeding affect fetal Doppler parameters during genetic amniocentesis?

İskender

Tarım

Çok

et al. 2014

J Turkish German Gynecol Assoc

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Results: Bleeding at the insertion point during amniocentesis did not significantly change the UARI (34% increase for Group 1 and 46.5% increase for Group 2, p=0.238), the MCARI (52% increase for Group 1 and 45% increase for Group 2, p=0.622), or the MCAPSV (37% increase for Group 1 and 49% increase for Group 2, p=0.199). UARI, MCARI, MCA PI, and MCAPSV were not significantly altered following amniocentesis in Groups 1 and 2. There was a significant increase in UAPI following amniocentesis only in Group 2. Abstract peak systolic velocity, the highest velocity was used. All of the invasive procedures and Doppler evaluation were performed by a single operator. The study was approved by the ethics and educational issues coordinating committee of the institution where the study was conducted. All of the patients signed written consent that their data could be used with appropriate ethical committee approval prior to genetic amniocentesis. Conclusion:

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Section: Discussionmentioning

confidence: 86%

Does bleeding affect fetal Doppler parameters during genetic amniocentesis?

İskender

Tarım

Çok

et al. 2014

J Turkish German Gynecol Assoc

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“…The Ibele approach reports observation of the fetus with serial ultrasound and intervention before the development of fetal hydrops as heralded by fetal abdominal ascites, scalp edema, worsening placentomegaly, and anemia [14]. They follow middle cerebral artery peak systolic velocity, which has been shown to be a good parameter for the evaluation of fetal anemia [20][21][22] diagnosing moderate and severe anemia in fetuses with a sensitivity of 100% [20,22]. A publication from the University of California at San Francisco in 2011 by Byrne et al [23] presented outcomes based on specific ultrasonographic findings.…”

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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“…Without cardiac compromise or hydrops, 88% survival is quoted [111]. Perinatal mortality results from tumour avulsion, rupture or haemorrhage at delivery [112,113]. With cardiac compromise or hydrops mortality approaches 100% [111].…”

Section: Sacrococcygeal Teratomamentioning

confidence: 99%

Pathophysiological mechanisms of high-intensity focused ultrasound-mediated vascular occlusion and relevance to non-invasive fetal surgery

Shaw

Haar

Rivens

et al. 2014

J. R. Soc. Interface.

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ReviewCite this article: Shaw CJ, ter Haar GR, Rivens IH, Giussani DA, Lees CC. 2014 Pathophysiological mechanisms of high-intensity focused ultrasound-mediated vascular occlusion and relevance to non-invasive fetal surgery. J. R. Soc. High-intensity focused ultrasound (HIFU) is a non-invasive technology, which can be used occlude blood vessels in the body. Both the theory underlying and practical process of blood vessel occlusion are still under development and relatively sparse in vivo experimental and therapeutic data exist. HIFU would however provide an alternative to surgery, particularly in circumstances where serious complications inherent to surgery outweigh the potential benefits. Accordingly, the HIFU technique would be of particular utility for fetal and placental interventions, where open or endoscopic surgery is fraught with difficulty and likelihood of complications including premature delivery. This assumes that HIFU could be shown to safely and effectively occlude blood vessels in utero. To understand these mechanisms more fully, we present a review of relevant cross-specialty literature on the topic of vascular HIFU and suggest an integrative mechanism taking into account clinical, physical and engineering considerations through which HIFU may produce vascular occlusion. This model may aid in the design of HIFU protocols to further develop this area, and might be adapted to provide a non-invasive therapy for conditions in fetal medicine where vascular occlusion is beneficial.

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Spontaneous rupture of sacrococcygeal teratoma associated with acute fetal anemia

Abstract: Sacrococcygeal teratoma (SCT) is the most common

Cited by 21 publications

References 11 publications

Does bleeding affect fetal Doppler parameters during genetic amniocentesis?

Does bleeding affect fetal Doppler parameters during genetic amniocentesis?

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

Pathophysiological mechanisms of high-intensity focused ultrasound-mediated vascular occlusion and relevance to non-invasive fetal surgery

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