THE NATURAL-HISTORY OF SACROCOCCYGEAL TERATOMAS DIAGNOSED THROUGH ROUTINE OBSTETRIC SONOGRAM - A SINGLE INSTITUTION EXPERIENCE

Background/Purpose:The antenatal diagnosis of sacrococcygeal teratoma (SCT) is increasingly being made with fetal sonography. However, the n atural history of SCT detected on routine obstetric sonogram is not we ll defined. Methods: A retrospective chart review of 21 fetal SCT diag nosed on routine sonography at Hospital Sainte-Justine between 1980 an d 1997 were performed. The patients' clinical and sonographic characte ristics, prenatal, and perinatal outcomes were examined. Prognostic cr iteria were identified by correlating patients' characteristics with o utcome. Results: In utero mortality rate was 19% and perinatal mortali ty rate was 14%. The incidence of premature labor was 50%, Of the vari ous criteria examined as an independent variable, the presence of a so lid 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 fo r premature labor (100%). All of the perinatal deaths were attributabl e to tumor rupture. Conclusions: The course of sacrococcygeal teratoma diagnosed on routine sonograms is associated with a higher-than-expec ted incidence of prenatal and perinatal complications. Close antenatal follow-up for new onset polyhydramnios and the presence of a complete ly solid tumor will help optimize patient counseling and treatment. J Pediatr Surg 33:899-903. Copyright (C) 1998 by W.B. Saunders Company.