Abstract:
Background: This study aims to evaluate the outcomes of fetal sacrococcygeal teratoma (SCT) submitted to prenatal interventions. Methods: We performed a systematic literature review of fetal SCT patients and compared the outcomes between open fetal surgery and percutaneous intervention. In addition, we also compared the results of SCT fetuses who did not undergo any surgical intervention (NI). Results: We identified 16 cases of open fetal surgery (OS), 48 cases of percutaneous fetal intervention (PI), and 93 NI patients. The survival rate was 56.2% in OS, 45.8% in PI (p = 0.568), and 71.0% in NI patients. The gestational age at delivery was earlier in cases where there was no survival compared to cases where the fetuses did survive across all evaluated cohorts (OS: p = 0.033, PI: p < 0.001, NI: p < 0.001). The gestational weeks at delivery in OS and PI fetuses were more similar; however, OS tended to be performed later on in pregnancy, and the affected fetuses had more severe presented findings. In our evaluation, we determined that the presence of fetal hydrops and cardiac failure had no significant impact on survival in SCT cases. In NI patients, polyhydramnios was much higher in fetuses who did not survive compared to their surviving cohorts (p < 0.001). Conclusions: In conclusion, gestational age at delivery can affect the short-term prognosis of fetuses affected with sacrococcygeal teratomas. Regardless of the mode of delivery or the necessity for intervention during the fetal period, monitoring for complications, including polyhydramnios, can prevent premature delivery.
摘要:
背景:本研究旨在评估接受产前干预的胎儿骶尾部畸胎瘤(SCT)的结局。方法:我们对胎儿SCT患者进行了系统的文献回顾,并比较了开放胎儿手术和经皮介入治疗的结局。此外,我们还比较了未接受任何手术干预(NI)的SCT胎儿的结果.结果:我们确定了16例胎儿开放性手术(OS),经皮胎儿介入术(PI)48例,93名NI患者。OS生存率为56.2%,PI为45.8%(p=0.568),NI患者为71.0%。与所有评估队列中胎儿确实存活的情况相比,在没有存活的情况下,分娩时的胎龄更早(OS:p=0.033,PI:p<0.001,NI:p<0.001)。OS和PI胎儿分娩时的孕周更相似;然而,OS倾向于在怀孕后期进行,受影响的胎儿有更严重的表现。在我们的评价中,我们确定,在SCT病例中,胎儿积液和心力衰竭的存在对生存率没有显著影响.在NI患者中,与存活组相比,未存活的胎儿羊水过多的发生率要高得多(p<0.001).结论:总之,分娩时的胎龄可影响骶尾部畸胎瘤受累胎儿的短期预后。无论分娩方式或在胎儿期进行干预的必要性,监测并发症,包括羊水过多,可以防止早产。