title: Fetal cystic hygroma: the importance of natural history.
abstract: OBJECTIVE
  To evaluate the natural history of cystic hygroma (CH) in fetal and neonatal periods to enrich parental counselling. Ultrasonographic characteristics, associated syndromes, chromosomal anomalies, fetal cardiac pathology and life after birth were considered.
  
  
  METHODS
  From May 1985 to September 2010, 207 pregnancies were seen the authors' centre with suspected vascular-lymphatic fetal malformation: 156 of them had CH. Cases were followed up by telephone interview to determine fetal and neonatal outcomes. Chi-squared test was used for statistical analysis.
  
  
  RESULTS
  Among the 156 cases of CH, the condition was septated in 75% of cases, associated with other pathologies in 74%, and retronuchal in 88%. Intrauterine regression was seen in 36% of cases, with complete disappearance in 77%. The karyotype was normal in 55% of cases. Follow-up was completed in 85 cases and revealed 54 spontaneous abortions (63%) and 31 live births (37%). Amongst these, 21 out of 31 children had a favourable outcome (68%). A negative embryo-fetal outcome was significantly associated with CH being associated with other pathologies, such as hydrops, retronuchal position and altered karyotype. Spontaneous regression or resolution of CH was associated with live births.
  
  
  CONCLUSIONS
  The management of pregnancies with a diagnosis of fetal CH requires knowledge of natural history of the malformation for appropriate parental counselling.
authors.affiliation: Obstetrics and Gynaecology, Catholic University of Sacred Heart, Rome, Italy.
authors.forename: G
authors.initials: G
authors.lastname: Noia
authors.forename: M
authors.initials: M
authors.lastname: Pellegrino
authors.forename: L
authors.initials: L
authors.lastname: Masini
authors.forename: D
authors.initials: D
authors.lastname: Visconti
authors.forename: C
authors.initials: C
authors.lastname: Manzoni
authors.forename: G
authors.initials: G
authors.lastname: Chiaradia
authors.forename: A
authors.initials: A
authors.lastname: Caruso
mesh_terms: D000328:Adult; D005260:Female; D006801:Humans; D015160:Hydrops Fetalis / Q000000981:diagnostic imaging / Q000401:mortality*; D007558:Italy / Q000453:epidemiology; D018191:Lymphangioma, Cystic / Q000000981:diagnostic imaging / Q000401:mortality*; D011247:Pregnancy; D012075:Remission, Spontaneous; D012189:Retrospective Studies; D016216:Ultrasonography, Prenatal; D055815:Young Adult
keywords: Chromosomal abnormality; Congenital cardiac anomaly; Fetal cystic hygroma; Natural history; Prenatal diagnosis