Pregnancy and Long-Term Postnatal Outcomes of Congenital Sacrococcygeal Teratoma: A Single Institution's 18-Year Experience

IF 1.6 4区医学 Q4 DEVELOPMENTAL BIOLOGY Birth Defects Research Pub Date : 2024-10-18 DOI:10.1002/bdr2.2405

Ava D. Mandelbaum, Raphael C. Sun, Amanda J. H. Kim, Roya Sohaey, Melanie Hakar, Saharnaz Tavoosi, Lucy Ward, Monica Rincon, Allison J. Allen, Stephanie Dukhovny, Andrew H. Chon

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Abstract

Objective

The objective of this study is to evaluate outcomes of fetal sacrococcygeal teratoma (SCT) from an academic tertiary center.

Study Design

This is a retrospective study evaluating pregnancy and postnatal outcomes of fetal SCT management at a single institution between 2006 and 2023. Results are reported as median (range).

Results

Fourteen patients with fetal SCT were studied. Hydrops fetalis occurred in 2 (14.3%) cases. Pregnancy course included expectant management in 12 (85.7%) and palliative preterm induction in 1 patient (7.1%). Indications for delivering timing included fetal deterioration in 7 patients (50%), preeclampsia in 3 (21.4%), elective induction of delivery in 3 (21.4%), and preterm labor in 1 (7.1%). Delivery GA was 36.4 weeks (26.4–40.1 weeks), with 11 (78.5%) cesareans and 3 (21.4%) vaginal deliveries. There were 13 (92.9%) live births and 11 (78.6%) long-term survivors. Postnatal resection pathology demonstrated 7 (53.8%) mature, 3 (23.1%) immature, and 3 (23.1%) malignant SCTs. Of the 11 long-term survivors, 3 (27.3%) had teratoma recurrences, including 2 (18.2%) with metastatic disease requiring chemotherapy. Notable long-term complications involved gastrointestinal (n = 7, 63.6%), genitourinary (n = 4, 36.4%), and musculoskeletal (n = 2, 18.2%) systems.

Conclusion

SCT confers significant morbidity to both the pregnant patient and neonate. Multidisciplinary prenatal and postnatal care is needed to comprehensively manage this complex condition.

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先天性骶尾部畸胎瘤的妊娠和产后长期疗效：一家医疗机构的 18 年经验

研究目的本研究旨在评估一家三级学术中心的胎儿骶尾部畸胎瘤（SCT）的治疗效果。研究设计这是一项回顾性研究，评估 2006 年至 2023 年间在一家医疗机构进行胎儿骶尾部畸胎瘤治疗的妊娠和产后结局。结果以中位数（范围）报告。结果研究了 14 例胎儿 SCT 患者。2例（14.3%）发生了胎儿水肿。12名患者（85.7%）的妊娠过程包括预产期管理，1名患者（7.1%）的妊娠过程包括姑息性早产引产。时机分娩的指征包括：7 名患者（50%）的胎儿情况恶化、3 名患者（21.4%）的子痫前期、3 名患者（21.4%）的选择性引产和 1 名患者（7.1%）的早产。产程为 36.4 周（26.4-40.1 周），其中 11 例（78.5%）剖宫产，3 例（21.4%）阴道分娩。活产 13 例（92.9%），长期存活 11 例（78.6%）。产后切除病理显示，7 例（53.8%）为成熟性 SCT，3 例（23.1%）为不成熟性 SCT，3 例（23.1%）为恶性 SCT。在11名长期存活者中，3人（27.3%）畸胎瘤复发，其中2人（18.2%）患有转移性疾病，需要接受化疗。值得注意的长期并发症涉及胃肠道系统（7 例，占 63.6%）、泌尿生殖系统（4 例，占 36.4%）和肌肉骨骼系统（2 例，占 18.2%）。结论 SCT 会给孕妇和新生儿带来严重的发病率。需要多学科的产前和产后护理来全面处理这种复杂的病症。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Birth Defects Research Medicine-Embryology

CiteScore

3.60

自引率

9.50%

发文量

153

期刊介绍： The journal Birth Defects Research publishes original research and reviews in areas related to the etiology of adverse developmental and reproductive outcome. In particular the journal is devoted to the publication of original scientific research that contributes to the understanding of the biology of embryonic development and the prenatal causative factors and mechanisms leading to adverse pregnancy outcomes, namely structural and functional birth defects, pregnancy loss, postnatal functional defects in the human population, and to the identification of prenatal factors and biological mechanisms that reduce these risks. Adverse reproductive and developmental outcomes may have genetic, environmental, nutritional or epigenetic causes. Accordingly, the journal Birth Defects Research takes an integrated, multidisciplinary approach in its organization and publication strategy. The journal Birth Defects Research contains separate sections for clinical and molecular teratology, developmental and reproductive toxicology, and reviews in developmental biology to acknowledge and accommodate the integrative nature of research in this field. Each section has a dedicated editor who is a leader in his/her field and who has full editorial authority in his/her area.