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Differential risk for neonatal surgical airway intervention in prenatally diagnosed neck masses.
Steigman, Shaun A; Nemes, Luanne; Barnewolt, Carol E; Estroff, Judy A; Valim, Clarissa; Jennings, Russell W; Fauza, Dario O.
Afiliación
  • Steigman SA; Department of Surgery, Children's Hospital Boston and Harvard Medical School, MA 02115, USA.
J Pediatr Surg ; 44(1): 76-9, 2009 Jan.
Article en En | MEDLINE | ID: mdl-19159721
PURPOSE: We aimed to identify risk factors for neonatal surgical airway intervention among fetuses with prenatally diagnosed cervical masses. METHODS: An 8-year retrospective review identified 23 consecutive patients with a prenatal diagnosis of a neck mass, managed at a single tertiary center. Variables analyzed included anticipated diagnosis, extent of the mass, need for any surgical airway intervention in the neonatal period, final histopathology data, and survival. Statistical analysis was based on the Fisher and Fisher-Freeman-Halton exact tests (significance set at P < or = .05) and exact 95% confidence intervals for risk differences. RESULTS: Eight patients underwent termination of pregnancy or were lost to follow-up. The imaging-based prenatal diagnosis was confirmed postnatally in 93% (14/15) of the remaining patients. Final diagnoses included lymphatic malformation (8), teratoma (6), and esophageal duplication (1). Teratomas were associated with a significantly higher risk for neonatal airway intervention than lymphatic malformations (67% vs 11%, P = .02). The majority of such procedures were performed under ex utero intrapartum treatment. Survival was 93% (14/15). CONCLUSIONS: Cervical teratomas are significantly more likely to demand surgical airway intervention in the neonate, typically under ex utero intrapartum treatment, than cervical lymphatic malformations. These findings should be considered in the prenatal counseling for fetal cervical masses.
Asunto(s)

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Teratoma / Neoplasias de Cabeza y Cuello / Sistema Linfático Tipo de estudio: Diagnostic_studies / Etiology_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Límite: Female / Humans / Newborn / Pregnancy Idioma: En Revista: J Pediatr Surg Año: 2009 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Estados Unidos

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Teratoma / Neoplasias de Cabeza y Cuello / Sistema Linfático Tipo de estudio: Diagnostic_studies / Etiology_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Límite: Female / Humans / Newborn / Pregnancy Idioma: En Revista: J Pediatr Surg Año: 2009 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Estados Unidos