Heloury Y, Vergnes P, Classe J M, Nomballais M F, Jehannin B, Weil D, Lopes P
Service de chirurgie pédiatrique, Hôtel-Dieu, Nantes.
Chir Pediatr. 1990;31(4-5):202-6.
Seventeen sacrococcygeal teratomas with prenatal diagnosis are studied. The diagnosis was made at 27 weeks. Three fetuses died in utero, two of them from the evolution of the tumor. Two died post-natally from hemorrhage and one post natally because of his prematurity. From the eleven long term survivors, one developed a recurrence and five sequelae. This study confirms the poor prognosis of fetal sacrococcygeal teratomas. The 2 major prognosis factors are the growth of the tumor and the occurrence of fetal congestive heart failure. That congestive heart failure is diagnosed by Doppler echocardiography before hydrops and placentomegaly who are of very poor prognosis. The extraction of the fetus is mandatory if these features appeared after 30 weeks. Before this term fetal surgery is the only effective treatment. At a long term, the risk of recurrence is low but implies a long term surveillance of the level of alfa foeto protein.
对17例产前诊断的骶尾部畸胎瘤进行了研究。诊断在孕27周时作出。3例胎儿死于宫内，其中2例死于肿瘤进展。2例出生后死于出血，1例出生后因早产死亡。在11例长期存活者中，1例出现复发，5例有后遗症。本研究证实胎儿骶尾部畸胎瘤预后不良。2个主要预后因素是肿瘤生长和胎儿充血性心力衰竭的发生。充血性心力衰竭可通过多普勒超声心动图在预后极差的水肿和胎盘肿大出现之前作出诊断。如果这些特征在30周后出现，则必须取出胎儿。在此孕周之前，胎儿手术是唯一有效的治疗方法。从长期来看，复发风险较低，但需要长期监测甲胎蛋白水平。
