PRENATAL-DIAGNOSIS AND PERINATAL MANAGEMENT OF FETAL SACROCOCCYGEAL TERATOMA

Sacrococcygeal teratoma is the most common fetal neoplasm, with an inc idence of 1 in 40,000 births. Fetuses with this malformation are at ri sk for significant perinatal morbidity and mortality. We identified ni ne fetuses with sacrococcygeal teratomas that were diagnosed antenatal ly and managed at the University of North Carolina Hospitals over a 7- year period. We reviewed retrospectively the charts of mothers and inf ants and recorded data concerning perinatal and surgical management. S ix infants survived the neonatal period. All infants diagnosed after 2 0 weeks' gestation survived. Fetal hydrops developed in three fetuses, all of whom died. Inadequate ventilation secondary to prematurity was a contributing factor in each lethal case. Diagnosis at an early gest ational age, development of fetal hydrops, and premature delivery pred icted a poor prognosis. When possible, we recommend that delivery be d elayed to allow for fetal development. Stabilization of the infant sho uld be attempted before resection of the teratoma.