[Perinatal and perianesthetic management of the sacrococcygeal teratoma in a neonate].
We report perinatal and perianesthetic management of a female infant with sacrococcygeal teratoma who underwent fetal bladder puncture and postnatal tumor resection. At 33 weeks' gestation, fetal ultrasonography revealed an intrapelvic mass, oligohydramnios and the dilatation of the bladder. At 34 weeks' gestation, bladder puncture was performed in utero to relieve urinary obstruction by the mass. And it served to reserve the renal function but caused remarkable ascites at birth due to urine leakage to the peritoneum through the puncture site. After the delivery by cesarean section, the patient underwent the tumor extirpation at 2 days of life. The operation and anesthesia proceeded uneventfully. In previous reports, several mortalities due to exsanguinating hemorrhage during surgery have been reported. In addition, sacrococcygeal teratoma is occasionally accompanied by coagulopathy and high output cardiac failure caused by arteriovenous fistulae. Therefore it is important for good patient outcomes to evaluate preoperatively the risks mentioned above.
Sasaoka
N
N
Department of Anesthesiology, Osaka Medical Center & Research Institute for Maternal & Child Health.
Kitamura
S
S
Kinouchi
K
K
Fukumitsu
K
K
Taniguchi
A
A
Tohda
A
A
D000768:Anesthesia, General; D003050:Coccyx; D005260:Female; D005315:Fetal Diseases / Q000000981:diagnostic imaging / Q000601:surgery*; D006801:Humans; D007231:Infant, Newborn; D019990:Perioperative Care; D011247:Pregnancy; D012447:Sacrum; D013125:Spinal Neoplasms / Q000151:congenital / Q000000981:diagnostic imaging / Q000601:surgery*; D013724:Teratoma / Q000151:congenital / Q000000981:diagnostic imaging / Q000601:surgery*; D016216:Ultrasonography, Prenatal; D001743:Urinary Bladder / Q000196:embryology