Course and outcome of a pregnancy with a giant fetal cervical teratoma diagnosed prenatally

We report the course and outcome of a pregnancy involving a giant fetal nec k teratoma which was diagnosed at 23 weeks of gestation. Sonographic survei llance of the fetal neck revealed continuing growth of the tumor with devel opment of polyhydramnios. Three-dimensional ultrasound provided additional detailed information on the external extent of the lesion. Color Doppler ul trasound showed intense arterial and venous flow with low resistance indice s. Cesarean section tinder general anesthesia was planned in close cooperat ion with the neonatologist, pediatric surgeon and anesthesiologist because the size of the neck mass precluded vaginal delivery. Cesarean section was performed at 34 weeks of gestation following preterm rupture of the membran es. Orotracheal intubation was not successful because of compression of the airway and a tracheostomy could not be performed because of the risk of se vere fetal hemorrhage from the tumor. The neonate died from respiratory ins ufficiency 66 min after birth.