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Outcomes following prenatal diagnosis of cystic hygroma: east midlands & south yorkshire congenital anomalies register (EMSYCAR) 2000–2009
  1. J L S Budd1,
  2. E Craft2,
  3. E S Draper1
  1. 1University of Leicester, Leicester, UK
  2. 2University Hospitals of Leicester NHS Trust, Leicester, UK

Abstract

Background Outcomes following the antenatal detection of a cystic hygroma are reported as poor. Most studies examining the outcome from antenatal diagnosis of a fetal anomaly are published from tertiary referral centres and these may not, therefore, reflect the true overall outcomes from these pregnancies. An early investigation from EMSYCAR 1997–1999 suggested a ‘normal’ outcome for <10% of such pregnancies.1

Method All cases of cystic hygroma prenatally diagnosed and reported to EMSYCAR, from 2000 to 2009, were identified. Pregnancy outcomes and confirmation of anomaly details following delivery were collected as part of the routine data follow-up for registry cases.

Results Over the 10 year period there were 653 687 births and 498 antenatally diagnosed cases of cystic hygroma: a population prevalence of 1:1313 births (95% CI 1:1202 to 1:1436). Of these 285 (57.2%) were TOPs, of which nearly two thirds (n=179, 62.8%) had an abnormal karyotype, 48 (16.8%) had further anomalies and 58 (20.4%) were isolated cases of cystic hygroma. Median gestation at TOP was 13 weeks (range 11 to 29) with 258/285 (90%) occurring <20 weeks – before any spontaneous regression of the hygroma, noted in other studies, might have occurred.

213 (42.8%) of the antenatally diagnosed cases opted to continue the pregnancy of which 90 (42%) resulted in a livebirth where the cystic hygroma had resolved and there were no reported anomalies.

Conclusion Parental counselling may need to be revised in view of these improved outcomes and the possibility of spontaneous regression of early diagnosed cases of cystic hygroma.

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