Amal Ayed1, Ann M Tonks2, Anthony Lander3, Mark D Kilby1,4. 1. The Fetal Medicine Centre, Birmingham Women's Foundation Trust, Birmingham, UK. 2. West Midlands Congenital Anomaly Register, Public Health England, Birmingham, UK. 3. Birmingham Children's Foundation Trust, Birmingham, UK. 4. Centre for Women's and Children's Health, Section Theme of Reproduction and Development, Institute of Metabolism & Allied Health Science, College of Medical and Dental Sciences, Birmingham, UK.
Abstract
OBJECTIVES: To describe the epidemiology and outcomes of sacrococcygeal teratoma (SCT) and identify the factors affecting prognosis in a population-based cohort. METHODS: Analyses of fetal SCTs from a population-based congenital anomaly register between 1995 and 2012, linked to regional datasets. A systematic literature review was performed for published studies on perinatal SCT (1995 to 2012). RESULTS: Thirty-six confirmed SCT cases were identified, giving a total prevalence of 0.30 per 10 000 births (95%CI 0.20-0.39). Twenty-three cases (63.9%) were diagnosed prenatally. There were six false positive prenatal diagnoses, and the positive predictive value of ultrasound for SCT was 79.3%. Secondary complications in prenatally diagnosed cases were polyhydramnios (27.2%), fetal hydrops (9.1%) and rapidly growing tumour (54.0%). The perinatal (PNMR) and infant mortality rates were 333.3 per 1000 births and 285.7 per 1000 live births, respectively. All stillbirths and infant deaths occurred in cases diagnosed prenatally. Factors associated with higher PNMR in registerable births were solid, vascular tumour composition (1000), polyhydramnios (667), premature delivery (667) and rapidly growing tumour (454). In the systematic review, prenatal hydrops fetalis and prematurity were the most morbid association in SCT. CONCLUSION: Prenatal ultrasound was relatively sensitive and specific in diagnosing SCT with good survival rates in live-born cases.
OBJECTIVES: To describe the epidemiology and outcomes of sacrococcygeal teratoma (SCT) and identify the factors affecting prognosis in a population-based cohort. METHODS: Analyses of fetal SCTs from a population-based congenital anomaly register between 1995 and 2012, linked to regional datasets. A systematic literature review was performed for published studies on perinatal SCT (1995 to 2012). RESULTS: Thirty-six confirmed SCT cases were identified, giving a total prevalence of 0.30 per 10 000 births (95%CI 0.20-0.39). Twenty-three cases (63.9%) were diagnosed prenatally. There were six false positive prenatal diagnoses, and the positive predictive value of ultrasound for SCT was 79.3%. Secondary complications in prenatally diagnosed cases were polyhydramnios (27.2%), fetal hydrops (9.1%) and rapidly growing tumour (54.0%). The perinatal (PNMR) and infant mortality rates were 333.3 per 1000 births and 285.7 per 1000 live births, respectively. All stillbirths and infant deaths occurred in cases diagnosed prenatally. Factors associated with higher PNMR in registerable births were solid, vascular tumour composition (1000), polyhydramnios (667), premature delivery (667) and rapidly growing tumour (454). In the systematic review, prenatal hydrops fetalis and prematurity were the most morbid association in SCT. CONCLUSION: Prenatal ultrasound was relatively sensitive and specific in diagnosing SCT with good survival rates in live-born cases.
Authors: Mehmet Özsürmeli; Selim Büyükkurt; Mete Sucu; Erol Arslan; Selahattin Mısırlıoğlu; Çiğdem Akçabay; Masum Kayapınar; Süleyman Cansun Demir; İsmail Cüneyt Evrüke Journal: Turk J Obstet Gynecol Date: 2020-10-02