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. 2021 Oct;41(11):1430-1438.
doi: 10.1002/pd.6026. Epub 2021 Aug 5.

Factors associated with poor outcome in fetuses prenatally diagnosed with sacrococcygeal teratoma

Lieke J van Heurn  1 , Audrey B C Coumans  2 , Joep P M Derikx  1 , Mireille N Bekker  3 , Katia M Bilardo  4 , Leonie K Duin  5 , Maarten F C M Knapen  6 , Eva Pajkrt  7 , Esther Sikkel  8 , L W Ernest van Heurn  1 , Dick Oepkes  9
Affiliations

Factors associated with poor outcome in fetuses prenatally diagnosed with sacrococcygeal teratoma

Lieke J van Heurn et al. Prenat Diagn. 2021 Oct.

Abstract

Aim of the study: Outcome of fetuses, prenatally diagnosed with sacrococcygeal teratoma (SCT), is still poorly documented. This study assesses the incidence and prenatal predictors of outcome in all fetuses prenatally diagnosed with SCT.

Methods: This is a retrospective study on all fetuses prenatally diagnosed with SCT from 1998 to 2018 in the Netherlands. Poor outcome was defined as terminations of pregnancy (TOP) because of expected unfavorable outcome, intrauterine fetal death, or early neonatal death. Potential risk factors for poor outcome were analyzed.

Main results: Eighty-four fetuses were included. Sixteen (19.0%) TOPs were excluded from statistical analysis. Eleven of the remaining 68 fetuses had poor outcome. Overall mortality was 32.1%, with a mortality excluding TOPs of 13.1%. Thirteen fetal interventions were performed in 11 (13.1%) fetuses. Potential risk factors for poor outcome were the presence of fetal hydrops (OR: 21.0, CI: 2.6-275.1, p = 0.012) and cardiomegaly (OR: 10.3, CI: 1.9-55.8, p = 0.011).

Conclusions: The overall mortality of fetuses prenatally diagnosed with SCTs including tTOP was 32.1%. This high mortality rate was mainly due to termination of pregnancy. Mortality excluding TOP was 13.1%. Potential risk factors for poor outcome were fetal hydrops and cardiomegaly.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

FIGURE 1
FIGURE 1
The outcomes of prenatally diagnosed sacrococcygeal teratoma (1998–2018)
FIGURE 2
FIGURE 2
Ultrasound of a cystic type I sacrococcygeal teratoma at 22 weeks'’ gestation. The fetus was delivered with planned cesarean section at 38 weeks' gestation because of breech position. The baby survived
FIGURE 3
FIGURE 3
Ultrasound of cystic Altman type III sacrococcygeal teratoma at 26 weeks' gestation. The fetus was born with a spontaneous vaginal delivery at 40 weeks' gestation. The baby survived
FIGURE 4
FIGURE 4
Ultrasound of type I hypervascular sacrococcygeal teratoma consisting of cystic and solid components at 21 weeks' gestation. This fetus received intrauterine transfusion at 26 weeks because of anemia. At 27 weeks, the fetus was delivered by cesarean section and died shortly after birth due to intratumor hemorrhage
FIGURE 5
FIGURE 5
Tumor volume index per gestational age for good and poor outcomes
See this image and copyright information in PMC

References

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