INCREASED DETECTION OF CYSTIC HYGROMA - A TECHNOLOGY-INDUCED PHENOMENON

In this study, we have determined the increasing rate of detection of cystic hygroma in an urban hospital-based Active Malformations Surveil lance Program during 1973-1974, 1979-1980, 1984-1985, and 1989-1990, A l affected infants were identified from a review of the findings in ei ther the findings in the pediatricians' examinations, the autopsy repo rts or the reports of finding in prenatal ultrasonography. The infants were subdivided by maternal transfer status and age (greater than or equal to 5 or <35), the presence of associated chromosome abnormalitie s and malformations and birth status. Eighty-four affected infants and fetuses were identified, 47 of whose mothers were nontransfers. Among the maternal nontransfers, the prevalence rate of cystic hygroma incr eased from 0.08/1,000 in 1973-1974 to 1.45/1,000 in 1988-1990. Initial ly, the diagnosis was made at birth in liveborn or stillborn infants, but by 1989-1990, only by prenatal ultrasonography. Most (71%) of the pregnancies with affected fetuses were terminated by choice following diagnosis with prenatal ultrasonography. A marked increase in the freq uency of examination by sonography during pregnancy was observed among a comparison group of women between 1974 and 1989. The progressive in crease in the detection of cystic hygroma in this time period was one effect of this more extensive use of prenatal ultrasound, better equip ment, and more experienced sonographers. (C) 1997 Wiley-Liss, Inc.