title: Evaluation of pregnancy and delivery in 13 women who underwent resection of a sacrococcygeal teratoma during early childhood.
abstract: BACKGROUND
  Sacrococcygeal teratoma resection often brings changes in pelvic anatomy and physiology with possible consequences for defecation, micturition and sexual function. It is unknown, whether these changes have any gynecological and obstetric sequelae. Until now four pregnancies after sacrococcygeal teratoma resection have been described and cesarean section has been suggested to be the method of choice for delivery. We evaluated the pregnancy course and mode of delivery in women previously treated for a sacrococcygeal teratoma.
  
  
  METHODS
  The records of all patients who underwent sacrococcygeal teratoma resection after 1970 in one of the six pediatric surgical centers in the Netherlands were reviewed retrospectively. Women aged 18 years and older were eligible for participation. Patient characteristics, details about the performed operation and tumor histology were retrieved from the records. Consenting participants completed a questionnaire addressing fertility, pregnancy and delivery details.
  
  
  RESULTS
  Eighty-nine women were eligible for participation; 20 could not be traced. Informed consent was received from 41, of whom 38 returned the completed questionnaire (92.7%). Thirteen of these 38 women conceived, all but one spontaneously. In total 20 infants were born, 17 by vaginal delivery and 3 by cesarean section, in one necessitated by previous intra-abdominal surgery as a consequence of sacrococcygeal teratoma resection. Conversion to a cesarean section was never necessary. None of the 25 women without offspring reported involuntary childlessness.
  
  
  CONCLUSIONS
  There are no indications that resection of a sacrococcygeal teratoma in female patients is associated with reduced fertility: spontaneous pregnancy is possible and vaginal delivery is safe for mother and child, irrespective of the sacrococcygeal teratoma classification or tumor histology.
authors.affiliation: Department of Pediatric Surgery, Maastricht University Medical Center, Maastricht, The Netherlands. Marijke.Kremer@mumc.nl.
authors.forename: Marijke E B
authors.initials: ME
authors.lastname: Kremer
authors.affiliation: Department of Pediatric Surgery, Maastricht University Medical Center, Maastricht, The Netherlands. M.koeneman@alumni.maastrichtuniversity.nl.|Department of Gynecology and Obstetrics, Maastricht University Medical Center, Maastricht, The Netherlands. M.koeneman@alumni.maastrichtuniversity.nl.
authors.forename: Margot M
authors.initials: MM
authors.lastname: Koeneman
authors.affiliation: Department of Pediatric Surgery, Maastricht University Medical Center, Maastricht, The Netherlands. j.derikx@mumc.nl.
authors.forename: Joep P M
authors.initials: JP
authors.lastname: Derikx
authors.affiliation: Department of Gynecology and Obstetrics, Maastricht University Medical Center, Maastricht, The Netherlands. a.coumans@mumc.nl.
authors.forename: Audrey
authors.initials: A
authors.lastname: Coumans
authors.affiliation: Department of Pediatric Surgery, University Medical Center Groningen, Groningen, The Netherlands. r.van.baren@umcg.nl.
authors.forename: Robertine
authors.initials: R
authors.lastname: van Baren
authors.affiliation: Pediatric Surgical Center of Amsterdam, Emma Children's Hospital University Medical Center and VU Medical Center, Amsterdam, The Netherlands. h.a.heij@amc.uva.nl.
authors.forename: Hugo A
authors.initials: HA
authors.lastname: Heij
authors.affiliation: Department of Pediatric Surgery, University Medical Center Nijmegen, Nijmegen, The Netherlands. marc.wijnen@radboudumc.nl.
authors.forename: Marc H W A
authors.initials: MH
authors.lastname: Wijnen
authors.affiliation: Department of Pediatric Surgery, Sophia Children's Hospital, Erasmus University Medical Center Rotterdam, Rotterdam, The Netherlands. r.wijnen@erasmusmc.nl.
authors.forename: René M H
authors.initials: RM
authors.lastname: Wijnen
authors.affiliation: Department of Pediatric Surgery, Wilhelmina Children's Hospital, University Medical Center Utrecht, Utrecht, The Netherlands. D.C.vanderZee@umcutrecht.nl.
authors.forename: David C
authors.initials: DC
authors.lastname: van der Zee
authors.affiliation: Department of Pediatric Surgery, Maastricht University Medical Center, Maastricht, The Netherlands. e.van.heurn@mumc.nl.
authors.forename: Ernest L W
authors.initials: EL
authors.lastname: van Heurn
mesh_terms: D000293:Adolescent; D000328:Adult; D002585:Cesarean Section; D036861:Delivery, Obstetric; D005260:Female; D006801:Humans; D009035:Mothers; D009426:Netherlands; D011247:Pregnancy; D012189:Retrospective Studies; D012445:Sacrococcygeal Region / Q000601:surgery*; D011795:Surveys and Questionnaires; D013724:Teratoma / Q000150:complications* / Q000601:surgery*; D055815:Young Adult