The prenatal diagnosis and perinatal outcomes of fetal intra-abdominal cysts

Yıl 2015, Cilt: 46 Sayı: 2, 69 - 75, 16.03.2015

Pınar Kumru , Resul Arısoy , Emre Erdoğdu Oya Demirci , Elif Tozkır , Sevcan Arınkan , Ahmet Tuğrul , Ayşenur Cerrah Celayir , Birol Durukan

https://doi.org/10.16948/zktb.95145

Öz

Objective: The aim of this study is to evaluate the perinatal ultrasonographic findings and perinatal outcome after prenatal diagnosis of fetal abdominal cysts.

Methods: Fetuses diagnosed with abdominal cysts between 2008 and 2013 were retrospectively analysed. We analyzed maternal, fetal and perinatal variables for all cases.

Results: Eighteen fetuses 3 of that are males (16.7%) and 15 are females (83.3%) with the diagnosis of fetal abdominal cyst were analysed. The mean gestational age at diagnosis of a fetal abdominal cyst was 26.78±6.75 weeks. The mean diameter of fetal abdominal cyst was 39.81±20.47 mm at the time of diagnosis. There were 15 liveborn cases and two intrauterine deaths. One case was terminated due to multiple anomalies. Fetal abdominal cyst was resolved in four cases during antenatal follow-up period. Surgery was required in six cases neonatally (40%). Overall spontaneous mortality was 3/17 (17.6%), of which two cases were intrauterine and one case was postoperative.

Conclusions: Parents should be informed about associated anomalies, perinatal, and postnatal outcomes of fetal intra-abdominal cysts. These results may be useful for prenatal counseling of fetal abdominal cyst.

Anahtar Kelimeler

fetus, abdomen, cysts, ultrasonography, prenatal diagnosis, pregnancy outcomes

Fetal intra-abdominal kistlerin prenatal tanı ve perinatal sonuçları

Öz

Amaç: Bu çalışmanın amacı, perinatal tanı alan fetal abdominal kist olgularının ultrason bulguları ve perinatal sonuçlarının değerlendirilmesidir.

Materyal ve Metod: 2008-2013 yılları arasında Fetal abdominal kist tanısı almış olgular retrospektif olarak incelenmiştir. Maternal, fetal  ve perinatal veriler incelenmiştir.

Bulgular: 18 fetal abdominal kist olgusundan üçü (%16,7) erkek 15’i (%83,3) kız fetustü.  Fetal abdominal kist tanı  konulan ortalama gebelik haftası 26,78±6,75 hafta idi. Tanıda ortalama fetal abdominal kist çapı 39,81±20,47 mm olarak saptandı.  15 olgu canlı doğum ile ve 2 olgu intrauterin ölüm ile sonuçlandı. Bir olgu multiple anomali nedeni ile termine edildi. Fetal abdominal kisti olan dört olgu intrauterin hayatta kayboldu. Altı olgunun (%40) cerrahi müdahale gereksinimi oldu. Total spontan mortalite 3/17 (%17,6) olarak, iki olguda intrauterin dönemde, bir olguda postoperatif dönemde meydana geldi.

Sonuç: Aileler Fetal abdominal kistlerle ilişkili anomaliler ve peri-postnatal sonuçları hakkında bilgilendirilmelidir. Bu sonuçlar fetal abdominal kist  olgularının danışmanlığında kullanılabilir.

Anahtar Kelimeler

Fetüs, Karın, Kistler, Ultrasonografi, Prenatal Tanı, Gebelik Sonuçları

Kaynakça

• Sherwood W, Boyd P, Lakhoo K. Postnatal outcome of antenatally diagnosed intra-abdominal cysts. Pediatr Surg Int 2008;24:763–5.
• Bryant AE, Laufer MR. Fetal ovarian cysts: Incidence, diagnosis and management. J Reprod Med 2004;49:329–37.
• Khalil A, Cooke PC, Mantovani E, Bhide A, Papageorghiou AT, Thilaganathan B. Outcome of first-trimester fetal abdominal cysts: cohort study and review of the literature. Ultrasound Obstet Gynecol 2014;43:413-9.
• Hyett J. Intra-abdominal masses: prenatal differential diagnosis and management. Prenat Diagn 2008;28:645-55.
• Fremond B, Poulain P, Odent, Dudgeon D. Prenatal detection of a congenital pancreatic cyst and Beckwith–Wiedemann syndrome. Prenat Diagn 1997;17:276–80.
• Laje P, Martinez-Ferro M, Grisoni E, Dudgeon D. Intra-abdominal pulmonary sequestration. A case series and review of the literature. J Pediatr Surg 2006;41:1309-12.
• Słodki M, Janiak K, Respondek-Liberska M, Szaflik K, Wilczyński J, Oszukowski P, Chilarski A. Assessment of the usefulness of ultrasound screening in fetal ovarian cysts. Ginekol Pol 2008;79:120-5.
• D’Addario V, Volpe P, Kurjak A, Lituania M, Zmijanac J. Ultrasonic diagnosis and perinatal management of complicated and uncomplicated fetal ovarian cysts: a collaborative study. J Perinat Med 1990;18:375–81.
• Bagolan P, Giorlandino C, Nahom A, Bilancioni E, Trucchi A, Gatti C, Aleandri V, Spina V. The management of fetal ovarian cysts. J Pediatr Surg 2002;37:25–30.
• Słodki M, Respondek-Liberska M. Fetal ovarian cysts 420 cases from literature--metaanalysis 1984-2005. Ginekol Pol 2007;78:324-8.
• Schenkman L, Weiner TM, Phillips JD. Evolution of the surgical management of neonatal ovarian cysts: laparoscopic-assisted transumbilical extracorporeal ovarian cystectomy (LATEC). J Laparoendosc Adv Surg Tech A 2008;18:635-40.
• Brantberg A, Blaas HG, Haugen SE, Isaksen CV, Eik-Nes SH. Imperforate anus: A relatively common anomaly rarely diagnosed prenatally. Ultrasound Obstet Gynecol 2006; 28:904-10.
• Ochoa JH, Chiesa M, Vildoza RP, Wong AE, Sepulveda W. Evaluation of the perianal muscular complex in the prenatal diagnosis of anorectal atresia in a high-risk population. Ultrasound Obstet Gynecol 2012;39:521-7.
• Murken JD, Albert A. Genetic counselling in cases of anal and rectal atresia. Prog Pediatr Surg 1976;9:115–8.
• Richards DS, Langham MR, Anderson CD. The prenatal sonographic appearance of enteric duplication cysts. Ultrasound Obstet Gynecol. 1996;7:17-20.
• Meyberg-Solomayer GC, Buchenau W, Solomayer EF, Fehm T, Hacker HW, Wallwiener D, Poets C. Cystic colon duplication as differential diagnosis to ovarian cyst. Fetal Diagn Ther. 2006;21:224-7.
• Macken MB, Wright JR Jr, Lau H, Cooper MC, Grantmyre EB, Thompson DL, O'Brien MK. Prenatal sonographic detection of congenital hepatic cyst in third trimester after normal second-trimester sonographic examination. J Clin Ultrasound 2000;28:307-10.
• Bronstein M, Nizar K, Weiner Z. Significance of early prenatal diagnosis of fetal hepatic cyst. J Clin Ultrasound 2009;37:65-8.
• Chan KL, Tang MH, Tse HY, Tang RY, Tam PK. Meconium peritonitis: prenatal diagnosis, postnatal management and outcome. Prenat Diagn 2005;25:676-82.
• Saleh N, Geipel A, Gembruch U, Heep A, Heydweiller A, Bartmann P, Franz AR, Müller A. Prenatal diagnosis and postnatal management of meconium peritonitis. J Perinat Med 2009;37:535-8.
• Ozyuncu O, Canpolat FE, Ciftci AO, Yurdakok M, Onderoglu LS, Deren O. Perinatal outcomes of fetal abdominal cysts and comparison of prenatal and postnatal diagnoses. Fetal Diagn Ther 2010;28:153-9.