title: Late-onset isolated cystic hygroma: the obstetrical significance, management, and outcome.
abstract: We add two cases of prenatally diagnosed late-onset isolated cystic hygroma to the eight cases reported previously in the English literature. The obstetrical significance, management, and outcome of this entity are reviewed. A retrospective study of late-onset isolated cystic hygromas delivered in one medical centre between 1978 and 1992 was made. The medical records of these newborns served as the basis of the present report. A Medline search of the English literature was carried out. Over a period of 15 years, we observed 11 cases of late-onset congenital isolated cystic hygroma, two of whom had prenatal sonographic diagnosis. In one case, a Caesarean section was performed due to a huge lesion. All cases underwent surgical excision with a favourable outcome. Of the eight prenatally diagnosed cases reported previously, one died at bith due to inability to ventilate and two required a tracheostomy. Late-onset isolated cystic hygroma should be differentiated from the early-onset nuchal cystic hygroma. The differential diagnosis is important, as late-onset isolated cystic hygroma does not require any prenatal intervention, but special awareness during labour and Caesarean section in extreme cases. Transport to a perinatal centre with expert neonatal, respiratory, and paediatric surgical care is recommended. The prognosis in general is favourable.
authors.affiliation: Department of Obstetrics and Gynecology, Rambam Medical Center, Haifa, Israel.
authors.forename: I
authors.initials: I
authors.lastname: Goldstein
authors.forename: P
authors.initials: P
authors.lastname: Jakobi
authors.forename: G
authors.initials: G
authors.lastname: Shoshany
authors.forename: S
authors.initials: S
authors.lastname: Filmer
authors.forename: I
authors.initials: I
authors.lastname: Itskoviz
authors.forename: B
authors.initials: B
authors.lastname: Maor
mesh_terms: D002585:Cesarean Section; D003937:Diagnosis, Differential; D005260:Female; D005865:Gestational Age; D006801:Humans; D007231:Infant, Newborn; D007743:Labor, Obstetric; D018191:Lymphangioma, Cystic / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000601:surgery; D008297:Male; D011247:Pregnancy; D011296:Prenatal Diagnosis; D011379:Prognosis; D016216:Ultrasonography, Prenatal