Characteristics and outcome of fetal cystic hygroma diagnosed in the first trimester.
OBJECTIVE
The aim of this study was to determine the course of pregnancy and the neonatal outcome of fetuses with cystic hygroma diagnosed at 10-14 weeks' gestation.


METHODS
Maternal and fetal data (nuchal translucency, karyotype, pregnancy outcome) in cases of fetal cystic hygroma, admitted or referred to our antenatal diagnostic centre, were prospectively entered into a computer database. Paediatric outcome was analysed when relevant.


RESULTS
Some 72 fetuses had cystic hygroma. The mean size of the cystic hygroma was 7.9 mm. Chromosomal abnormalities were present in 52.7% of cases (38/72), including 14 cases (36.8%) of Down syndrome. A total of 34 chromosomally normal pregnancies gave rise to 18 live births (52.9%), with no visible serious structural abnormalities. The outcome of pregnancy was unfavourable (miscarriage, elective termination, serious structural abnormalities) in 77.7% of cases (56/72). The 18 live-born infants were followed up for 17-98 months. Sixteen infants developed normally, while 1 developed Noonan's syndrome and 1 had a urinary tract abnormality (pyelo-ureteral junction; PUJ).


CONCLUSIONS
These data suggest that the prognosis of fetal cystic hygroma detected during the first trimester is poor, and show that sonographic evaluation of fetal nuchal translucency thickness in the first trimester is crucial.
Graesslin
Olivier
O
Department of Obstetrics and Gynecology, Institut Mère-Enfant Alix de Champagne, CHU Reims, Reims, France. ograesslin@chu-reims.fr <ograesslin@chu-reims.fr>
Derniaux
Emilie
E
Alanio
Elisabeth
E
Gaillard
Dominique
D
Vitry
Fabien
F
Quéreux
Christian
C
Ducarme
Guillaume
G
D000293:Adolescent; D000328:Adult; D000649:Amniocentesis; D002869:Chromosome Aberrations / Q000196:embryology; D005260:Female; D005602:France / Q000453:epidemiology; D006801:Humans; D007231:Infant, Newborn; D018191:Lymphangioma, Cystic / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000196:embryology / Q000453:epidemiology; D009333:Neck / Q000000981:diagnostic imaging / Q000196:embryology; D048208:Nuchal Translucency Measurement; D011247:Pregnancy; D011256:Pregnancy Outcome; D011261:Pregnancy Trimester, First; D011296:Prenatal Diagnosis; D011446:Prospective Studies