Preemptive Delivery and Immediate Resection for Fetuses with High-Risk Sacrococcygeal Teratomas.
Fetal Diagn Ther
; 45(3): 137-144, 2019.
Article
em En
| MEDLINE
| ID: mdl-29734172
ABSTRACT
INTRODUCTION:
Fetuses with "high-risk" sacrococcygeal teratoma (SCT) have a mortality rate of 40-50%. While fetal surgery may benefit select fetuses prior to 27 weeks' gestation, many fetuses die due to consequences of rapid tumor growth after 27 weeks. Here we report our experience applying "preemptive" delivery to fetuses who manifest signs of decompensation between 27 and 32 weeks.METHODS:
A retrospective review of SCT fetuses delivered between 2010 and 2016 at ≤32 weeks' gestation was performed. Patients who decompensated prior to 27 weeks and were treated with fetal surgery or neonatal palliation were excluded.RESULTS:
Forty-two SCT fetuses were evaluated, and 11 were preemptively delivered in response to impending fetal or maternal decompensation. Nine (81.8%) survived. One death was due to pulmonary hypoplasia in a neonate with significant intra-abdominal tumor burden, and the other was due to in utero tumor rupture. There were no deaths related to prematurity in this cohort.CONCLUSIONS:
Many fetuses with SCT manifest signs of decompensation between 27 and 32 weeks. In the absence of fetal hydrops prior to 27 weeks or tumor rupture in utero, early delivery is associated with favorable outcomes. Our single-center experience supports a management algorithm change to incorporate "preemptive" delivery for selected cases.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Temas:
Geral
/
Tipos_de_cancer
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Outros_tipos
Base de dados:
MEDLINE
Assunto principal:
Região Sacrococcígea
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Neoplasias da Coluna Vertebral
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Teratoma
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Doenças Fetais
Tipo de estudo:
Diagnostic_studies
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Etiology_studies
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Observational_studies
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Risk_factors_studies
Limite:
Female
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Humans
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Male
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Newborn
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Pregnancy
Idioma:
En
Revista:
Fetal Diagn Ther
Assunto da revista:
DIAGNOSTICO POR IMAGEM
/
OBSTETRICIA
/
PERINATOLOGIA
Ano de publicação:
2019
Tipo de documento:
Article