After a diagnosis, both mother and baby will be monitored often to watch the progression of the mass. A fetal echocardiogram will also be used to monitor the teratoma during pregnancy to track the development of heart failure and any risk of hydrops (fluid buildup).
Our fetal care team will also work with families to provide informed treatment plans based on the type, size, and composition of a fetal sacrococcygeal teratoma (verified by a fetal MRI). They'll also take into account the complications the mass is causing to determine if fetal surgery is required.
The standard treatment process for small, benign fetal sacrococcygeal teratomas includes:
- Observation: In pregnancies with no/low risk of cardiac complication, the teratoma is monitored with ultrasounds.
- Post-birth resection: Once the baby is delivered, the tumor is removed within the first 2-3 days of life. Babies usually stay in the hospital for 5-7 days after surgery until they are feeding normally with no concerns about pain or healing.
However, for larger or malignant tumors that are posing a risk to cardiac, lung or bowel functions, prenatal surgery may be recommended by our fetal care team.
Treatment for these types of sacrococcygeal teratomas include:
- Aspiration of dominant cysts: In certain cases of sacrococcygeal teratomas, a dominant large cyst may pose a risk for obstruction or rupture. In this case, aspiration of the cyst contents (removal of fluid with a needle) can be performed in utero to stabilize the baby. Follow-up for this procedure includes frequent ultrasounds to monitor the baby’s growth, as well as fluid levels in the cyst.
- EXIT procedure: This is a special delivery technique where the sacrococcygeal teratoma is exposed through a limited incision in the uterus. The portion of the teratoma located outside the baby's pelvis is removed while on placental support. Then, uterus is closed and the remainder of the tumor will be removed after the baby is born. This staged surgical process is used to prevent tumor rupture and hemorrhaging should the mother go into spontaneous labor.
Treatment for sacrococcygeal teratomas at the Colorado Fetal Care Center has proven very successful. Thanks to our amazing team, sacrococcygeal teratoma surgeries have improved outcomes for our tiniest patients and their mothers.