Large fetal sacrococcygeal teratomas: could early delivery improve outcome?
Cynthia J Holcroft1, Karin J Blakemore, Edith D Gurewitsch
1Department of Gynecology and Obstetrics, Johns Hopkins University School of Medicine, Baltimore, MD, USA. cholcroft@jhmi.edu
Objective:
To determine if gestational age (GA) at delivery or tumor size impacts outcome in neonates with very large sacrococcygeal teratomas (SCTs).
Methods:
Retrospective chart review from 1990 to 2006 of live-born infants with very large SCTs, defined as diameters exceeding 10 cm. Data analyzed using the independent t test and Fisher's exact test, with p values <0.05 considered significant.
Results:
Nine infants with very large SCTs were identified. Six of the 9 infants survived, 4 of whom had evidence of early hydrops. Mean GA of survivors was 32.2 +/- 3.7 versus 31.7 +/- 0.6 weeks in nonsurvivors (p = 0.85). Infants with the largest SCTs did not survive.
Conclusion:
Risks of preterm delivery must be weighed against complications from further enlargement of very large SCTs and against the risks of in utero intervention.
