Prenatal diagnosis and outcomes of fetal teratomas.

PURPOSE: Our aim was to evaluate the diagnostic performance of ultrasonography (US) in the prenatal identification of teratomas and the perinatal outcome of the fetuses with those teratomas. METHODS: In this retrospective case series study, we searched the archives using the keywords "fetal mass" or "fetal tumor" or "fetal teratoma" and "sacrococcygeal teratoma," diagnosed between 2009 and 2014, within the US database of our center. RESULTS: One hundred seven fetuses were prenatally diagnosed as having a cystic or solid mass, tumor, or teratoma. Nineteen of those cases were diagnosed prenatally as having fetal teratoma, but that diagnosis could not be verified in three cases. In one fetus, the prenatal diagnosis could not be confirmed. The sensitivity of US in identifying fetal teratoma was 100% and the false-positive rate, 3.3%. Six pregnancies complicated by a fetal teratoma were terminated. A normal karyotype was identified in all fetuses that underwent karyotyping. Among the nine women who continued their pregnancy, polyhydramnios was identified in four fetuses; although high-output heart failure was also identified in two of those fetuses during prenatal follow-up, none developed hydrops. On delivery, nine infants were born alive, but three (33.3%) of them died within the early neonatal period. CONCLUSIONS: US has very high sensitivity and low false-positive rates in identifying fetal teratoma prenatally. The risk of chromosomal abnormalities is very low in fetuses with teratoma, and their prognosis depends on the location and size of the tumor and any associated perinatal complications.

Pregnancy outcomes by mode of delivery among breech births.

OBJECTIVE: To compare maternal and neonatal outcomes of the vaginal delivery versus cesarean delivery for the breech presentation. METHODS: We reviewed the maternal and neonatal charts of all singleton breech deliveries of <1,000, 1,000-1,500, 1,501-2,500, 2,501-4,000, and >4,000 g delivered between 2000 and 2006 at our institution. The study population consisted of 1,537 women with a fetus in a breech presentation. A group of 478 women that had delivered vaginally was compared with a group of 1,059 women, who had cesarean delivery, regarding neonatal mortality and morbidity (asphyxia, bone fractures, intraventricular hemorrhage, convulsions, respiratory distress syndrome, necrotizing enterocolitis, congenital hip dislocation), and maternal morbidity (febrile morbidity, anemia, wound infection). RESULTS: Neonatal complications did not differ between the group of women with term babies, <1,000 g babies, >1,500 g babies in breech presentation for women that had vaginal delivery and those that had cesarean delivery. On the other hand, breech presentation in preterm delivery between 1,000 and 1,500 g birth weight appears an independent risk factor for the neonatal mortality. There were fewer maternal complications in the vaginal group than in the cesarean group. CONCLUSION: Vaginal delivery of 1,000-1,500 g babies presenting as breech is associated with the increased neonatal mortality compared with cesarean delivery. Cesarean delivery is associated with maternal morbidity compared with the vaginal delivery.

Serum lipids level assessed in early pregnancy and risk of pre-eclampsia.

AIM: The purpose of this study investigated the relationship between early pregnancy plasma lipid concentrations and risk of pre-eclampsia. MATERIAL AND METHODS: In a prospective cohort study, maternal blood samples were collected between 10-20 weeks of gestation. From the cohort, we selected 30 women who developed pre-eclampsia and 320 who remained normotensive and served as control subjects. Linear logistic regression test was used for confounding factors identification. RESULTS: Women who subsequently developed pre-eclampsia had higher concentrations of fasting plasma, total cholesterol and triglycerides than in those remaining normotensive group. After using linear logistic regression analyses for the potential confounding factors, triglyceride concentrations were significantly higher in pre-eclamptic cases as compared with control. CONCLUSION: Early pregnancy dyslipidemia, particularly hypertriglyceridemia appears associated with increased risk of pre-eclampsia.