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The natural history of sacrococcygeal teratomas diagnosed through routine obstetric sonogram: a single institution
A X Holterman1, D Filiatrault, M Lallier
1Department of Surgery, Hospital Sainte-Justine, Montreal, Quebec, Canada.
Background/Purpose:
The antenatal diagnosis of sacrococcygeal teratoma (SCT) is increasingly being made with fetal sonography. However, the natural history of SCT detected on routine obstetric sonogram is not well defined.
Methods:
A retrospective chart review of 21 fetal SCT diagnosed on routine sonography at Hospital Sainte-Justine between 1980 and 1997 were performed. The patients' clinical and sonographic characteristics, prenatal, and perinatal outcomes were examined. Prognostic criteria were identified by correlating patients' characteristics with outcome.
Results:
In utero mortality rate was 19% and perinatal mortality rate was 14%. The incidence of premature labor was 50%. Of the various criteria examined as an independent variable, the presence of a solid tumor was found to be a important negative prognostic factor with a 67% incidence of death in utero and an overall mortality rate of 100%. Patients with new onset polyhydramnios were at significant risks for premature labor (100%). All of the perinatal deaths were attributable to tumor rupture.
Conclusions:
The course of sacrococcygeal teratoma diagnosed on routine sonograms is associated with a higher-than-expected incidence of prenatal and perinatal complications. Close antenatal follow-up for new onset polyhydramnios and the presence of a completely solid tumor will help optimize patient counseling and treatment.