Outcome of fetal cystic hygroma and experience of intrauterine treatment

Keiko Ogita, Sachiyo Suita, Tomoaki Taguchi, Takeshi Yamanouchi, Kouji Masumoto, Kiyomi Tsukimori, Hitoo Nakano

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Abstract

Objective: To review our cases of fetal cystic hygroma and to examine the prognostic factors with the goal of establishing criteria for the intrauterine treatment for cystic hygroma. Patients and Methods: Thirty-one cases of fetal cystic hygroma were managed by us from January 1988 to December 1997, and 21 cases were available for analysis. Three prognostic factors, namely chromosomal abnormality, structural anomaly and hydrops fetalis, were evaluated. We treated 2 cases of cystic hygroma associated with hydrops fetalis in utero using OK-432 injection under ultrasound guidance. Results: The fetuses without any of the prognostic factors listed above showed a good prognosis throughout the fetal and neonatal periods. However, in this group, 2 infants with large tumors died of hemorrhage from the tumor at 6 months and 3 years of age, respectively. Cases with hydrops fetalis without chromosomal abnormalities or structural anomalies (5 cases) resulted in either intrauterine fetal death (IUFD, 2 cases) or early perinatal neonatal death (early PND, 3 cases). The cause of early PND was circulatory failure. Most of the hydrops cases with either a chromosomal abnormality or structural anomaly resulted in IUFD before 22 weeks of gestation. The size of the cyst decreased in 1 of 2 cases treated in utero. Conclusions: The fetal cases of cystic hygroma showing hydrops fetalis without chromosomal abnormalities or structural anomalies are considered to be possible candidates for intrauterine therapy. Those with very large cystic hygroma without any of the three prognostic factors are also thought to be candidates for fetal treatment. Based on our clinical experience, sclerotherapy using OK-432 is considered to be a treatment option in selected cases with fetal cystic hygroma.

Original languageEnglish
Pages (from-to)105-110
Number of pages6
JournalFetal Diagnosis and Therapy
Volume16
Issue number2
DOIs
Publication statusPublished - Mar 6 2001

All Science Journal Classification (ASJC) codes

  • Pediatrics, Perinatology, and Child Health
  • Embryology
  • Radiology Nuclear Medicine and imaging
  • Obstetrics and Gynaecology

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    Ogita, K., Suita, S., Taguchi, T., Yamanouchi, T., Masumoto, K., Tsukimori, K., & Nakano, H. (2001). Outcome of fetal cystic hygroma and experience of intrauterine treatment. Fetal Diagnosis and Therapy, 16(2), 105-110. https://doi.org/10.1159/000053891