[Prenatal diagnosis of sacro-coccygeal teratomas]

Seventeen sacrococcygeal teratomas with prenatal diagnosis are studied. The diagnosis was made at 27 weeks. Three fetuses died in utero, two of them from the evolution of the tumor. Two died post-natally from hemorrhage and one post natally because of his prematurity. From the eleven long term survivors, one developed a recurrence and five sequelae. This study confirms the poor prognosis of fetal sacrococcygeal teratomas. The 2 major prognosis factors are the growth of the tumor and the occurrence of fetal congestive heart failure. That congestive heart failure is diagnosed by Doppler echocardiography before hydrops and placentomegaly who are of very poor prognosis. The extraction of the fetus is mandatory if these features appeared after 30 weeks. Before this term fetal surgery is the only effective treatment. At a long term, the risk of recurrence is low but implies a long term surveillance of the level of alfa foeto protein.