Fetal intrapericardial teratomas

Fetal intrapericardial teratomas are rare and benign. However, they canbe life-threatening owing to the complicated massive pericardial effusions,tamponade, or cardiorespiratory distress. The purpose of this review is togive an overview on clinical features, management and prognoses of fetalintrapericardial teratomas. The materials of this study were based on acomprehensive literature retrieval of fetal intrapericardial teratomas publishedin the past two decades. It was noteworthy that fetal pericardial/pleuraleffusions or ascites were detected since 19-week gestation, and tumors couldbe found since 21-week gestation. A growing trend of tumors was observed inmore than half of the cases. Prenatal centesis and postnatal tumor resectionwere required in most of the cases. Fetoneonatal deaths (including fetaldemise, termination of pregnancy and neonatal death) occurred in one-thirdof the cases. The neonatal survival rate was 59.4%. Symptomatic fetusesusually required perinatal maneuvers, such as pericardiocentesis, or thoraco-/pericardio-amniotic shunt in order to improve fetal hemodynamic status andprolong the pregnancy for lung maturity. Open fetal surgery and ex uterointrapartum treatment (EXIT) procedure can be considered, however, impactof EXIT procedure on later delivery remains uncertain. Postnatal operationis a curative and symptom-relieving method for those cases with prenatallydiagnosed intrapericardial teratomas. As a result, the fetoneonatal outcomesare somewhat promising.

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