Prenatal management of fetal intrapericardial teratoma: a systematic review

Objectives The purpose of this systematic review is to provide a comprehensive overview on the clinical course, perinatal outcome and effectiveness of antenatal management options for pericardial teratoma. Methods A comprehensive search including Ovid MEDLINE, Ovid EMBASE, and Scopus was conducted from inception to September 2016. All studies that reported the antenatal course of pericardial teratoma in singleton or twin gestations were considered eligible Standardized forms were used for data abstraction by two independent reviewers. Results Out of 217 screened abstracts, 59 studies reporting 67 fetuses with pericardial teratoma were included. 23 singleton fetuses and 3 fetuses in twin gestations underwent prenatal treatment and 20(76.9%) of them were hydropic at the time of intervention. Of those, 15/20(75%) had a favorable outcome. In the non-intervention group (n=41), 26(63.4%) developed hydrops and out of those, 8(30.8%) had a favorable outcome. Conclusion Antenatal fluid drainage and other antenatal techniques have been utilized in the treatment of intrapericardial teratoma. While most fetuses tolerated pericardiocentesis, the neonatal benefit of this procedure is still uncertain and outcomes of other interventions had variable success. Antenatal intervention for pericardial teratoma may be an option in specialized units, but given the maternal and fetal risks, needs careful consideration.