Children's Hospital of Philadelphia, Philadelphia, Pennsylvania,
Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA.
Fetal Diagn Ther. 2019;45(2):94-101. doi: 10.1159/000486782. Epub 2018 Mar 1.
Tumor volume to fetal weight ratio (TFR) > 0.12 before 24 weeks has been associated with poor outcome in fetuses with sacrococcygeal teratoma (SCT). We evaluated TFR in predicting poor fetal outcome and increased maternal operative risk in our cohort of SCT pregnancies.
This is a retrospective, single-center review of fetuses seen with SCT from 1997 to 2015. Patients who chose termination of pregnancy (TOP), delivered elsewhere, or had initial evaluation at > 24 weeks were excluded. Receiver operating characteristic (ROC) analysis determined the optimal TFR to predict poor fetal outcome and increased maternal operative risk. Poor fetal outcome included fetal demise, neonatal demise, or fetal deterioration warranting open fetal surgery or delivery < 32 weeks. Increased maternal operative risk included cases necessitating open fetal surgery, classical cesarean delivery, or ex utero intrapartum treatment (EXIT).
Of 139 pregnancies with SCT, 27 chose TOP, 14 delivered elsewhere, and 40 had initial evaluation at > 24 weeks. Thus, 58 fetuses were reviewed. ROC analysis revealed that at ≤24 weeks, TFR > 0.095 was predictive of poor fetal outcome and TFR > 0.12 was predictive of increased maternal operative risk.
This study supports the use of TFR at ≤24 weeks for risk stratification of pregnancies with SCT.
在 24 周前肿瘤体积与胎儿体重比（TFR）>0.12 与骶尾部畸胎瘤（SCT）胎儿的不良结局相关。我们评估了 TFR 在预测我们的 SCT 妊娠队列中不良胎儿结局和增加母亲手术风险中的作用。
这是一项对 1997 年至 2015 年期间患有 SCT 的胎儿进行的回顾性、单中心研究。选择终止妊娠（TOP）、在其他地方分娩或在>24 周时进行初始评估的患者被排除在外。接受者操作特征（ROC）分析确定了预测不良胎儿结局和增加母亲手术风险的最佳 TFR。不良胎儿结局包括胎儿死亡、新生儿死亡或需要开放胎儿手术或分娩<32 周的胎儿恶化。增加的母亲手术风险包括需要开放胎儿手术、经典剖宫产或宫外分娩治疗（EXIT）的病例。
在 139 例患有 SCT 的妊娠中，27 例选择 TOP，14 例在其他地方分娩，40 例在>24 周时进行了初始评估。因此，对 58 例胎儿进行了回顾。ROC 分析显示，在≤24 周时，TFR>0.095 可预测不良胎儿结局，TFR>0.12 可预测增加母亲手术风险。
这项研究支持在≤24 周时使用 TFR 对 SCT 妊娠进行风险分层。
