Ahmed A Nassr1,2, Sherif A Shazly3, Shaine A Morris4, Nancy Ayres4, Jimmy Espinoza1, Hadi Erfani1, Olutoyin A Olutoye5, Sara K Sexson4, Oluyinka O Olutoye6, Charles D Fraser7, Michael A Belfort1, Alireza A Shamshirsaz1. 1. Department of Obstetrics and Gynecology, Baylor College of Medicine and Texas Children's Fetal Center, Houston, TX, USA. 2. Women's Health Hospital, Assiut University, Assiut, Egypt. 3. Department of Obstetrics and Gynecology, Mayo Clinic College of Medicine, Rochester, MN, USA. 4. Division of Pediatric Cardiology, Baylor College of Medicine and Texas Children's Fetal Center, Houston, TX, USA. 5. Division of Pediatric Anesthesia, Baylor College of Medicine and Texas Children's Fetal Center, Houston, TX, USA. 6. Division of Pediatric Surgery, Baylor College of Medicine and Texas Children's Fetal Center, Houston, TX, USA. 7. Division of Congenital Heart Surgery, Baylor College of Medicine and Texas Children's Heart Center, Houston, TX, USA.
Abstract
OBJECTIVES: The purpose of this systematic review is to provide a comprehensive overview on the clinical course, perinatal outcome, and effectiveness of prenatal management options for pericardial teratoma. METHODS: A comprehensive search including Ovid MEDLINE, Ovid EMBASE, and Scopus was conducted from inception to September 2016. All studies that reported the prenatal course of pericardial teratoma in singleton or twin gestations were considered eligible. Standardized forms were used for data abstraction by two independent reviewers. RESULTS: Out of 217 screened abstracts, 59 studies reporting 67 fetuses with pericardial teratoma were included. Twenty-three singleton fetuses and 3 fetuses in twin gestations underwent prenatal treatment, and 20 (76.9%) of them were hydropic at the time of intervention. Of those, 15/20 (75%) had a favorable outcome. In the non-intervention group (n = 41), 26 (63.4%) developed hydrops, and out of those, 8 (30.8%) had a favorable outcome. CONCLUSION: Prenatal fluid drainage and other prenatal techniques have been utilized in the treatment of intrapericardial teratoma. While most fetuses tolerated pericardiocentesis, the neonatal benefit of this procedure is still uncertain, and outcomes of other interventions had variable success. Prenatal intervention for pericardial teratoma may be an option in specialized units but, given the maternal and fetal risks, needs careful consideration.
OBJECTIVES: The purpose of this systematic review is to provide a comprehensive overview on the clinical course, perinatal outcome, and effectiveness of prenatal management options for pericardial teratoma. METHODS: A comprehensive search including Ovid MEDLINE, Ovid EMBASE, and Scopus was conducted from inception to September 2016. All studies that reported the prenatal course of pericardial teratoma in singleton or twin gestations were considered eligible. Standardized forms were used for data abstraction by two independent reviewers. RESULTS: Out of 217 screened abstracts, 59 studies reporting 67 fetuses with pericardial teratoma were included. Twenty-three singleton fetuses and 3 fetuses in twin gestations underwent prenatal treatment, and 20 (76.9%) of them were hydropic at the time of intervention. Of those, 15/20 (75%) had a favorable outcome. In the non-intervention group (n = 41), 26 (63.4%) developed hydrops, and out of those, 8 (30.8%) had a favorable outcome. CONCLUSION: Prenatal fluid drainage and other prenatal techniques have been utilized in the treatment of intrapericardial teratoma. While most fetuses tolerated pericardiocentesis, the neonatal benefit of this procedure is still uncertain, and outcomes of other interventions had variable success. Prenatal intervention for pericardial teratoma may be an option in specialized units but, given the maternal and fetal risks, needs careful consideration.