The impact of 3-dimensional ultrasonography on perinatal management of a large epignathus teratoma without ex utero intrapartum treatment

Rodrigo Ruano, Alexandra Benachi, Marie Cecile Aubry, Sophie Parat, Marc Dommergues, Yves Manach

Research output: Contribution to journalArticle

13 Scopus citations

Abstract

We report a case of epignathus teratoma diagnosed at 22 weeks of gestation in which 3-dimensional ultrasound (3DUS) was useful to plan perinatal management. A significant enlargement of the tumor, associated with polyhydramnios and preterm labor, was observed at 35 weeks of gestation. After amniotic fluid evacuation, 3DUS was performed in the presence of pediatricians, obstetricians, and otolaryngologists. Three-dimensional ultrasound revealed that great part of the tumor was located outside the fetal mouth and anterior to fetal mandible, suggesting that the newborn could breathe spontaneously by nasal via. A cesarean section with longitudinal hysterotomy was performed at 36 weeks followed by an immediate extirpation of the tumor and the intubation of the newborn. The management of this rare case illustrates that the ex utero intrapartum treatment (EXIT) procedure is not always necessary in this situation. Besides, the actual prenatal goal consists on carefully selecting fetuses with epignathus teratoma that will need the EXIT procedure from those that will not. Three-dimensional ultrasound and magnetic resonance imaging in association with 2DUS can be helpful in this prenatal selection.

Original languageEnglish (US)
JournalJournal of Pediatric Surgery
Volume40
Issue number11
DOIs
StatePublished - Nov 1 2005
Externally publishedYes

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Keywords

  • 3-Dimensional ultrasound
  • Epignathus
  • EXIT procedure
  • Magnetic resonance imaging
  • Prenatal diagnosis
  • Teratoma
  • Ultrasound

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Surgery

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