Late-onset isolated cystic hygroma: The obstetrical significance,management, and outcome |
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Authors: | Israel Goldstein MD Peter Jakobi Gideon Shoshany Shlomo Filmer Ioseph Itskoviz Bar Maor |
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Institution: | 1. Departments of Obstetrics and Gynecology, Rambam Medical Center, Haifa, Israel;2. Departments of Pediatric Surgery, Rambam Medical Center, Haifa, Israel |
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Abstract: | We add two cases of prenatally diagnosed late-onset isolated cystic hygroma to the eight cases reported previously in the English literature. The obstetrical significance, management, and outcome of this entity are reviewed. A retrospective study of late-onset isolated cystic hygromas delivered in one medical centre between 1978 and 1992 was made. The medical records of these newborns served as the basis of the present report. A Medline search of the English literature was carried out. Over a period of 15 years, we observed 11 cases of late-onset congenital isolated cystic hygroma, two of whom had prenatal sonographic diagnosis. In one case, a Caesarean section was performed due to a huge lesion. All cases underwent surgical excision with a favourable outcome. Of the eight prenatally diagnosed cases reported previously, one died at birth due to inability to ventilate and two required a tracheostomy. Late-onset isolated cystic hygroma should be differentiated from the early-onset nuchal cystic hygroma. The differential diagnosis is important, as late-onset isolated cystic hygroma does not require any prenatal intervention, but special awareness during labour and Caesarean section in extreme cases. Transport to a perinatal centre with expert neonatal, respiratory, and paediatric surgical care is recommended. The prognosis in general is favourable. |
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Keywords: | Isolated cystic hygroma prenatal diagnosis ultrasound |
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