Abstract：
BACKGROUND: Fetal intrapericardial teratoma is a rare tumor that can be diagnosed by antenatal ultrasonography early in pregnancy.
METHODS: A fetal intrapericardial teratoma was detected on routine ultrasonography in the second trimester of pregnancy. At 31 weeks gestation, a marked increase in tumor size, fetal ascites, and pericardial effusion were observed, indicating that preterm delivery would be inevitable. Corticosteroid prophylaxis (24 mg of betamethasone in two doses of 12 mg 24 h apart) initiated for prophylaxis of respiratory distress syndrome led to a reduction in fetal ascites and pericardial effusion. Betamethasone therapy (4 mg/per day) was continued with the aim to postpone the expected date of delivery. Gestation was extended for more than 2 weeks. At 33 weeks and 5 days gestation, the neonate was delivered by elective cesarean section with ex utero intrapartum treatment and immediately submitted to fetal cardiac surgery. The infant was discharged from the hospital in good health about 4 months later.
CONCLUSIONS: The present report draws attention to improvement in fetal status and extension of gestation achieved with maternal low-dose corticosteroid therapy on antenatal ultrasound finding of fetal ascites and pericardial effusion due to intrapericardial teratoma.
METHODS: A fetal intrapericardial teratoma was detected on routine ultrasonography in the second trimester of pregnancy. At 31 weeks gestation, a marked increase in tumor size, fetal ascites, and pericardial effusion were observed, indicating that preterm delivery would be inevitable. Corticosteroid prophylaxis (24 mg of betamethasone in two doses of 12 mg 24 h apart) initiated for prophylaxis of respiratory distress syndrome led to a reduction in fetal ascites and pericardial effusion. Betamethasone therapy (4 mg/per day) was continued with the aim to postpone the expected date of delivery. Gestation was extended for more than 2 weeks. At 33 weeks and 5 days gestation, the neonate was delivered by elective cesarean section with ex utero intrapartum treatment and immediately submitted to fetal cardiac surgery. The infant was discharged from the hospital in good health about 4 months later.
CONCLUSIONS: The present report draws attention to improvement in fetal status and extension of gestation achieved with maternal low-dose corticosteroid therapy on antenatal ultrasound finding of fetal ascites and pericardial effusion due to intrapericardial teratoma.
摘要：
引言胎儿心包内畸胎瘤是一种罕见的肿瘤，可在妊娠早期通过产前超声检查诊断。病例介绍妊娠中期常规超声检查发现胎儿心包内畸胎瘤。妊娠31周时，肿瘤大小明显增加，胎儿腹水,观察到心包积液，这表明早产是不可避免的。为预防呼吸窘迫综合征而开始的皮质类固醇预防（24mg倍他米松，间隔12mg24小时两次）可减少胎儿腹水和心包积液。继续使用倍他米松治疗（4mg/天），目的是推迟预期的分娩日期。妊娠延长2周以上。妊娠33周零5天，新生儿通过选择性剖宫产术和子宫外产时治疗(EXIT)分娩,并立即接受胎儿心脏手术.婴儿约4个月后健康出院。结论本报告提请注意母体低剂量皮质类固醇治疗对胎儿腹水和心包积液的产前超声发现的胎儿状况改善和妊娠延长。
