High Tumor Volume to Fetal Weight Ratio Is Associated with Worse Fetal Outcomes and Increased Maternal Risk in Fetuses with Sacrococcygeal Teratoma
Objective: 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. Methods: This i...
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| Veröffentlicht in: | Fetal diagnosis and therapy 2019-01, Vol.45 (2), p.94-101 |
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| creator | Gebb, Juliana S. Khalek, Nahla Qamar, Huma Johnson, Mark P. Oliver, Edward R. Coleman, Beverly G. Peranteau, William H. Hedrick, Holly L. Flake, Alan W. Adzick, N. Scott Moldenhauer, Julie S. |
| description | Objective: 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. Methods: 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). Results: 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. Conclusion: This study supports the use of TFR at ≤24 weeks for risk stratification of pregnancies with SCT. |
| doi_str_mv | 10.1159/000486782 |
| format | Article |
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Scott ; Moldenhauer, Julie S.</creator><creatorcontrib>Gebb, Juliana S. ; Khalek, Nahla ; Qamar, Huma ; Johnson, Mark P. ; Oliver, Edward R. ; Coleman, Beverly G. ; Peranteau, William H. ; Hedrick, Holly L. ; Flake, Alan W. ; Adzick, N. Scott ; Moldenhauer, Julie S.</creatorcontrib><description>Objective: 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. Methods: 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). Results: 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. Conclusion: This study supports the use of TFR at ≤24 weeks for risk stratification of pregnancies with SCT.</description><identifier>ISSN: 1015-3837</identifier><identifier>EISSN: 1421-9964</identifier><identifier>DOI: 10.1159/000486782</identifier><identifier>PMID: 29495013</identifier><language>eng</language><publisher>Basel, Switzerland: S. Karger AG</publisher><subject>Adult ; Complications and side effects ; Female ; Fetal Death ; Fetal surgery ; Fetal Weight ; Fetoscopy ; Health aspects ; Humans ; Labor complications ; Logistic Models ; Maternal-fetal exchange ; Multivariate Analysis ; Original Paper ; Patient outcomes ; Perinatal Death ; Pregnancy ; Pregnancy Outcome ; Retrospective Studies ; Risk Assessment ; Risk factors ; ROC Curve ; Sacrococcygeal Region - diagnostic imaging ; Sacrococcygeal Region - pathology ; Sacrococcygeal Region - surgery ; Teratoma ; Teratoma - diagnostic imaging ; Teratoma - pathology ; Teratoma - surgery ; Tumor Burden ; Ultrasonography, Prenatal</subject><ispartof>Fetal diagnosis and therapy, 2019-01, Vol.45 (2), p.94-101</ispartof><rights>2018 S. Karger AG, Basel</rights><rights>2018 S. Karger AG, Basel.</rights><rights>COPYRIGHT 2019 S. Karger AG</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c432t-8d0e52c4ccc0b99dc7156e6b81545c4c9116c835887ae59d88e5fa9a6c8629db3</citedby><cites>FETCH-LOGICAL-c432t-8d0e52c4ccc0b99dc7156e6b81545c4c9116c835887ae59d88e5fa9a6c8629db3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,2429,4024,27923,27924,27925</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/29495013$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Gebb, Juliana S.</creatorcontrib><creatorcontrib>Khalek, Nahla</creatorcontrib><creatorcontrib>Qamar, Huma</creatorcontrib><creatorcontrib>Johnson, Mark P.</creatorcontrib><creatorcontrib>Oliver, Edward R.</creatorcontrib><creatorcontrib>Coleman, Beverly G.</creatorcontrib><creatorcontrib>Peranteau, William H.</creatorcontrib><creatorcontrib>Hedrick, Holly L.</creatorcontrib><creatorcontrib>Flake, Alan W.</creatorcontrib><creatorcontrib>Adzick, N. Scott</creatorcontrib><creatorcontrib>Moldenhauer, Julie S.</creatorcontrib><title>High Tumor Volume to Fetal Weight Ratio Is Associated with Worse Fetal Outcomes and Increased Maternal Risk in Fetuses with Sacrococcygeal Teratoma</title><title>Fetal diagnosis and therapy</title><addtitle>Fetal Diagn Ther</addtitle><description>Objective: 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. Methods: 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). Results: 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. Conclusion: This study supports the use of TFR at ≤24 weeks for risk stratification of pregnancies with SCT.</description><subject>Adult</subject><subject>Complications and side effects</subject><subject>Female</subject><subject>Fetal Death</subject><subject>Fetal surgery</subject><subject>Fetal Weight</subject><subject>Fetoscopy</subject><subject>Health aspects</subject><subject>Humans</subject><subject>Labor complications</subject><subject>Logistic Models</subject><subject>Maternal-fetal exchange</subject><subject>Multivariate Analysis</subject><subject>Original Paper</subject><subject>Patient outcomes</subject><subject>Perinatal Death</subject><subject>Pregnancy</subject><subject>Pregnancy Outcome</subject><subject>Retrospective Studies</subject><subject>Risk Assessment</subject><subject>Risk factors</subject><subject>ROC Curve</subject><subject>Sacrococcygeal Region - diagnostic imaging</subject><subject>Sacrococcygeal Region - pathology</subject><subject>Sacrococcygeal Region - surgery</subject><subject>Teratoma</subject><subject>Teratoma - diagnostic imaging</subject><subject>Teratoma - pathology</subject><subject>Teratoma - surgery</subject><subject>Tumor Burden</subject><subject>Ultrasonography, Prenatal</subject><issn>1015-3837</issn><issn>1421-9964</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2019</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNpt0VFrFDEQAOAgiq3VB99FAgWhD1uTzWY3eTyq1x5UCvW0j0sumb2Lvd0cSRbp7_APd9o7TwslDwmTLxNmhpD3nJ1yLvVnxlil6kaVL8ghr0peaF1XL_HMuCyEEs0BeZPSL2SqEfVrclDqSkvGxSH5c-GXKzof-xDpz7Aee6A50Clks6Y3gHeZXpvsA50lOkkpWG8yOPrb5xW9CTHBzl6N2YYeEjWDo7PBRjAJ3TfUccD7a59uqR8e9JiQPSb4bmwMNlh7twQ0c4gmh968Ja86s07wbrcfkR_Tr_Ozi-Ly6nx2NrksbCXKXCjHQJa2stayhdbONlzWUC8Ul5XEsOa8tkpIpRoDUjulQHZGGwzWpXYLcUSOt3mXZg2tH7qQo7G9T7ad1IJp0TRcoTp9RuFy0HsbBug8xp88-PTfgxVWllcJW4tdHNJTeLKF2IWUInTtJvrexLuWs_ZhsO1-sGg_bu1mXPTg9vLvJP8Vc2viEuIeTL_MtynajetQfXhW7X65B9M9scs</recordid><startdate>201901</startdate><enddate>201901</enddate><creator>Gebb, Juliana S.</creator><creator>Khalek, Nahla</creator><creator>Qamar, Huma</creator><creator>Johnson, Mark P.</creator><creator>Oliver, Edward R.</creator><creator>Coleman, Beverly G.</creator><creator>Peranteau, William H.</creator><creator>Hedrick, Holly L.</creator><creator>Flake, Alan W.</creator><creator>Adzick, N. Scott</creator><creator>Moldenhauer, Julie S.</creator><general>S. Karger AG</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope></search><sort><creationdate>201901</creationdate><title>High Tumor Volume to Fetal Weight Ratio Is Associated with Worse Fetal Outcomes and Increased Maternal Risk in Fetuses with Sacrococcygeal Teratoma</title><author>Gebb, Juliana S. ; Khalek, Nahla ; Qamar, Huma ; Johnson, Mark P. ; Oliver, Edward R. ; Coleman, Beverly G. ; Peranteau, William H. ; Hedrick, Holly L. ; Flake, Alan W. ; Adzick, N. Scott ; Moldenhauer, Julie S.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c432t-8d0e52c4ccc0b99dc7156e6b81545c4c9116c835887ae59d88e5fa9a6c8629db3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2019</creationdate><topic>Adult</topic><topic>Complications and side effects</topic><topic>Female</topic><topic>Fetal Death</topic><topic>Fetal surgery</topic><topic>Fetal Weight</topic><topic>Fetoscopy</topic><topic>Health aspects</topic><topic>Humans</topic><topic>Labor complications</topic><topic>Logistic Models</topic><topic>Maternal-fetal exchange</topic><topic>Multivariate Analysis</topic><topic>Original Paper</topic><topic>Patient outcomes</topic><topic>Perinatal Death</topic><topic>Pregnancy</topic><topic>Pregnancy Outcome</topic><topic>Retrospective Studies</topic><topic>Risk Assessment</topic><topic>Risk factors</topic><topic>ROC Curve</topic><topic>Sacrococcygeal Region - diagnostic imaging</topic><topic>Sacrococcygeal Region - pathology</topic><topic>Sacrococcygeal Region - surgery</topic><topic>Teratoma</topic><topic>Teratoma - diagnostic imaging</topic><topic>Teratoma - pathology</topic><topic>Teratoma - surgery</topic><topic>Tumor Burden</topic><topic>Ultrasonography, Prenatal</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Gebb, Juliana S.</creatorcontrib><creatorcontrib>Khalek, Nahla</creatorcontrib><creatorcontrib>Qamar, Huma</creatorcontrib><creatorcontrib>Johnson, Mark P.</creatorcontrib><creatorcontrib>Oliver, Edward R.</creatorcontrib><creatorcontrib>Coleman, Beverly G.</creatorcontrib><creatorcontrib>Peranteau, William H.</creatorcontrib><creatorcontrib>Hedrick, Holly L.</creatorcontrib><creatorcontrib>Flake, Alan W.</creatorcontrib><creatorcontrib>Adzick, N. Scott</creatorcontrib><creatorcontrib>Moldenhauer, Julie S.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><jtitle>Fetal diagnosis and therapy</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Gebb, Juliana S.</au><au>Khalek, Nahla</au><au>Qamar, Huma</au><au>Johnson, Mark P.</au><au>Oliver, Edward R.</au><au>Coleman, Beverly G.</au><au>Peranteau, William H.</au><au>Hedrick, Holly L.</au><au>Flake, Alan W.</au><au>Adzick, N. Scott</au><au>Moldenhauer, Julie S.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>High Tumor Volume to Fetal Weight Ratio Is Associated with Worse Fetal Outcomes and Increased Maternal Risk in Fetuses with Sacrococcygeal Teratoma</atitle><jtitle>Fetal diagnosis and therapy</jtitle><addtitle>Fetal Diagn Ther</addtitle><date>2019-01</date><risdate>2019</risdate><volume>45</volume><issue>2</issue><spage>94</spage><epage>101</epage><pages>94-101</pages><issn>1015-3837</issn><eissn>1421-9964</eissn><abstract>Objective: 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. Methods: 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). Results: 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. Conclusion: This study supports the use of TFR at ≤24 weeks for risk stratification of pregnancies with SCT.</abstract><cop>Basel, Switzerland</cop><pub>S. Karger AG</pub><pmid>29495013</pmid><doi>10.1159/000486782</doi><tpages>8</tpages></addata></record> |
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| ispartof | Fetal diagnosis and therapy, 2019-01, Vol.45 (2), p.94-101 |
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| source | Karger Journal Archive Collection; MEDLINE; Karger Journals; Alma/SFX Local Collection |
| subjects | Adult Complications and side effects Female Fetal Death Fetal surgery Fetal Weight Fetoscopy Health aspects Humans Labor complications Logistic Models Maternal-fetal exchange Multivariate Analysis Original Paper Patient outcomes Perinatal Death Pregnancy Pregnancy Outcome Retrospective Studies Risk Assessment Risk factors ROC Curve Sacrococcygeal Region - diagnostic imaging Sacrococcygeal Region - pathology Sacrococcygeal Region - surgery Teratoma Teratoma - diagnostic imaging Teratoma - pathology Teratoma - surgery Tumor Burden Ultrasonography, Prenatal |
| title | High Tumor Volume to Fetal Weight Ratio Is Associated with Worse Fetal Outcomes and Increased Maternal Risk in Fetuses with Sacrococcygeal Teratoma |
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