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Perinatal outcomes of antenatally investigated sacrococcygeal teratomas (SCTS) at a single tertiary fetal medicine centre
  1. B A Jones,
  2. G Paramasivam,
  3. E Nobili,
  4. M Noori,
  5. E Zhang,
  6. T G Teoh,
  7. R Wimalasundera,
  8. S Kumar
  1. Centre for Fetal Care, Queen Charlottes and Chelsea Hospital, London, London, UK

Abstract

Aims Sacrococcygeal teratomas (SCTs) are one of the commonest neonatal tumours but occur infrequently with an incidence of 1:40 000. We reviewed the perinatal outcomes of all antenatally detected cases of SCT at a single tertiary centre.

Methods Cases were identified from the fetal medicine database (between 2003 and 2010) and outcome data was obtained from the maternal, neonatal and surgical notes.

Results Eight SCTs were diagnosed. The median gestation at initial presentation was 23 (range 15–35 weeks). Two cases resulted in termination of pregnancy <16 weeks gestation (parental choice). Of the remaining cases, 2/6 required fetal intervention due to fetal hydrops, one requiring radiofrequency ablation and the other interstitial laser therapy of the vessels of the SCT. In addition, one of these cases required serial amniodrainage. The median gestation at delivery was 35 weeks (range 29–38 weeks) with 5/6 being delivered by caesarean section. All fetuses had excisional surgery at median of 4 days gestation (range 1–14 days). The neonate that had required radiofrequency ablation in utero, died aged at 11 days having being delivered at 29 weeks due to antepartum haemorrhage. 5/6 cases survived the neonatal period.

Conclusions: The overall neonatal survival of antenatally diagnosed SCT in this series is over 80%. The presence of associated fetal hydrops and need for fetal intervention was associated with a poorer prognosis.

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