Prenatal diagnosis and perinatal management of fetal sacrococcygeal teratoma

Sacrococcygeal teratoma is the most common fetal neoplasm, with an incidenc e of 1 in 40,000 births. Fetuses with this malformation ar-e at risk for si gnificant perinatal morbidity and mortality. We identified nine fetuses wit h sacrococcygeal teratomas that were diagnosed antenatally and managed at t he University of North Carolina Hospitals over a 7-year period. We retrospe ctively reviewed the charts of mothers and infants and recorded data concer ning perinatal and surgical management. Six infants survived the neonatal p eriod. All infants diagnosed after 20 weeks' gestation survived. Fetal hydr ops developed in three fetuses, all of whom died. Inadequate ventilation se condary to prematurity was a contributing factor in each lethal case. Diagn osis at an early gestational age, development of fetal hydrops, and prematu re delivery predicted a poor prognosis. When possible, we recommend that de livery be delayed to allow for fetal development. Stabilization of the infa nt should be attempted before resection of the teratoma.