YuanSM,胎儿心包内畸胎瘤。土耳其人JPediatr2019;61:153-158。胎儿心包内畸胎瘤罕见且良性。然而,由于复杂的大量心包积液,它们可能危及生命,填塞,或心肺窘迫。这篇综述的目的是概述临床特征,胎儿心包内畸胎瘤的治疗和预后.这项研究的材料是基于过去二十年来发表的胎儿心包内畸胎瘤的全面文献检索。值得注意的是,从妊娠19周开始检测到胎儿心包/胸腔积液或腹水,从妊娠21周开始就可以发现肿瘤。在超过一半的病例中观察到肿瘤的增长趋势。在大多数情况下,需要进行产前穿刺术和产后肿瘤切除术。胎儿胎儿死亡(包括胎儿死亡,终止妊娠和新生儿死亡)发生在三分之一的病例中。新生儿存活率为59.4%。有症状的胎儿通常需要围产期操作,比如心包穿刺术,或胸/心包-羊膜分流术,以改善胎儿血流动力学状态和延长妊娠肺成熟。可以考虑进行胎儿开放手术和子宫外产时治疗(EXIT)程序,然而,EXIT程序对后期交付的影响仍不确定。对于那些产前诊断为心包内畸胎瘤的病例,产后手术是一种治愈和缓解症状的方法。因此,胎儿产前结局有一定前景.
Yuan SM, Lin H. Fetal intrapericardial teratomas. Turk J Pediatr 2019; 61: 153-158. Fetal intrapericardial teratomas are rare and benign. However, they can be life-threatening owing to the complicated massive pericardial effusions, tamponade, or cardiorespiratory distress. The purpose of this review is to give an overview on clinical features, management and prognoses of fetal intrapericardial teratomas. The materials of this study were based on a comprehensive literature retrieval of fetal intrapericardial teratomas published in the past two decades. It was noteworthy that fetal pericardial/pleural effusions or ascites were detected since 19-week gestation, and tumors could be found since 21-week gestation. A growing trend of tumors was observed in more than half of the cases. Prenatal centesis and postnatal tumor resection were required in most of the cases. Fetoneonatal deaths (including fetal demise, termination of pregnancy and neonatal death) occurred in one-third of the cases. The neonatal survival rate was 59.4%. Symptomatic fetuses usually required perinatal maneuvers, such as pericardiocentesis, or thoraco-/ pericardio-amniotic shunt in order to improve fetal hemodynamic status and prolong the pregnancy for lung maturity. Open fetal surgery and ex utero intrapartum treatment (EXIT) procedure can be considered, however, impact of EXIT procedure on later delivery remains uncertain. Postnatal operation is a curative and symptom-relieving method for those cases with prenatally diagnosed intrapericardial teratomas. As a result, the fetoneonatal outcomes are somewhat promising.