Ultrasound prediction of fetal sacrococcygeal teratoma perinatal mortality

Sacrococcygeal teratoma (SCT) is a rare fetal tumour which results in significant fetal morbidity and mortality. Prenatal management requires identification of fetuses at greatest risk for perinatal mortality for targeted therapy. Our objective was to evaluate imaging parameters in this high-risk cohort for the prediction of neonatal mortality. A retrospective cohort analysis was performed from 2013-2023. Patient demographics, prenatal imaging findings and postnatal outcomes were obtained from electronic medical records. All variables were considered as binary categorical variables with fisher's exact tests performed followed by Receiver Operating Curves (ROC) for uni- and multivariate analyses. 32 patients were managed during the study period. Tumour to fetal weight ratio (TFR) and hydrops were significantly associated with perinatal death (p < 0.01). Significant ultrasonographic findings included hepatomegaly (p = 0.03), cardiomegaly p = 0.007), MCA Doppler >1.5 MoM (p < 0.01), abnormal DV Dopplers (p = 0.01) and abnormal UA Dopplers (p = 0.03). In multivariate analysis, abnormal DV Doppler and hepatomegaly yield the greatest prediction of perinatal demise (figure 1.: AUC= 0.95, p = 0.002). Several ultrasonographic findings are predictive of demise secondary to fetal SCT. Identification of hepatomegaly combined with abnormal DV Doppler has the highest prediction for demise. Beyond hydrops, reviewing these additional parameters may help guide management in this high-risk cohort for fetal intervention. Please note: The publisher is not responsible for the content or functionality of any supporting information supplied by the authors. Any queries (other than missing content) should be directed to the corresponding author for the article.