Marijke E B Kremer1, Lianne M Wellens1, Joep P M Derikx1, Robertine van Baren2, Hugo A Heij3, Marc H W A Wijnen4, René M H Wijnen5, David C van der Zee6, L W Ernest van Heurn7. 1. Department of Surgery-Maastricht University Medical Centre, Maastricht, the Netherlands. 2. Department of Paediatric Surgery-University Medical Centre Groningen, Groningen, the Netherlands. 3. Department of Paediatric Surgery-Surgical Centre of Amsterdam (Emma Children's Hospital AMC and VU Medical Centre), Amsterdam, the Netherlands. 4. Department of Paediatric Surgery-Radboud University Medical Centre, Nijmegen, the Netherlands. 5. Department of Paediatric Surgery-Erasmus Medical Centre-Sophia Children's Hospital, Rotterdam, the Netherlands. 6. Department of Paediatric Surgery-Wilhelmina Children's Hospital, University Medical Centre Utrecht, Utrecht, the Netherlands. 7. Department of Surgery-Maastricht University Medical Centre, Maastricht, the Netherlands. Electronic address: e.vanheurn@amc.uva.nl.
Abstract
BACKGROUND: A small percentage of neonates with sacrococcygeal teratoma die shortly after birth from hemorrhagic complications. The incidence of and risk factors associated with hemorrhagic mortality are unknown. In this multicenter study we determined the incidence of early death in neonates born with SCT and evaluated potential risk factors for hemorrhagic mortality. METHODS: 235 children with SCT treated from 1970 to 2010 in the Netherlands were retrospectively included. The following candidate risk factors for hemorrhagic mortality were examined: sex, prematurity, Altman type, tumor volume, tumor histology, necessity of emergency operation and time of diagnosis. RESULTS: Eighteen patients (7.7%) died at a median age of 163.5days (range 1.7-973days). Nine patients died of a malignancy. Nine others (3.8%) died postnatally (age 1-27days), six even within two days after birth. In seven of these nine patients death was related to tumor-hemorrhage and/or circulatory failure. Risk factors for hemorrhagic mortality were prematurity, tumor volume>1000cm3 and performance of an emergency operation. CONCLUSIONS: Hemorrhagic mortality of neonates with SCT is relatively high (3.8%) representing almost 70% of the overall mortality in the neonatal period. High-output cardiac failure, internal tumor hemorrhage and perioperative bleeding were the most common causes of early death and were all strongly associated with larger tumor sizes. LEVEL-OF-EVIDENCE RATING: II (Retrospective study).
BACKGROUND: A small percentage of neonates with sacrococcygeal teratoma die shortly after birth from hemorrhagic complications. The incidence of and risk factors associated with hemorrhagic mortality are unknown. In this multicenter study we determined the incidence of early death in neonates born with SCT and evaluated potential risk factors for hemorrhagic mortality. METHODS: 235 children with SCT treated from 1970 to 2010 in the Netherlands were retrospectively included. The following candidate risk factors for hemorrhagic mortality were examined: sex, prematurity, Altman type, tumor volume, tumor histology, necessity of emergency operation and time of diagnosis. RESULTS: Eighteen patients (7.7%) died at a median age of 163.5days (range 1.7-973days). Nine patients died of a malignancy. Nine others (3.8%) died postnatally (age 1-27days), six even within two days after birth. In seven of these nine patientsdeath was related to tumor-hemorrhage and/or circulatory failure. Risk factors for hemorrhagic mortality were prematurity, tumor volume>1000cm3 and performance of an emergency operation. CONCLUSIONS: Hemorrhagic mortality of neonates with SCT is relatively high (3.8%) representing almost 70% of the overall mortality in the neonatal period. High-output cardiac failure, internal tumor hemorrhage and perioperative bleeding were the most common causes of early death and were all strongly associated with larger tumor sizes. LEVEL-OF-EVIDENCE RATING: II (Retrospective study).
Authors: Lieke J van Heurn; Audrey B C Coumans; Joep P M Derikx; Mireille N Bekker; Katia M Bilardo; Leonie K Duin; Maarten F C M Knapen; Eva Pajkrt; Esther Sikkel; L W Ernest van Heurn; Dick Oepkes Journal: Prenat Diagn Date: 2021-08-05 Impact factor: 3.242
Authors: Oliver P Firszt; Jolanta Myga-Porosiło; Katarzyna Pośpieszny; Tomasz Golus; Sylwia Trzeszkowska-Rotkegel; Jan Głowacki; Wojciech Sraga; Ewa Kluczewska Journal: Pol J Radiol Date: 2018-01-25