Prenatally diagnosed fetal neck teratoma - Case report and novel management options

A case of fetal neck teratoma diagnosed at 32 weeks' gestation is reported. Planning before delivery included consultations with the neonatologist, the anesthesiologist, the otolaryngologist and the social worker. Delivery by cesarean section under epidural anesthesia was carried out at 34 weeks because of preterm labor. The head was delivered and the fetus was intubated within 4 1/2 min using a rigid bronchoscope. Magnesium sulfate and nitroglycerin provided uterine relaxation allowing fetal oxygenation via the uteroplacental circulation. Umbilical artery blood gases were satisfactory. The early neonatal course was complicated by hemorrhage from the teratoma externally as well as intratracheal bleeding and ventilatory problems. The baby died at 40 min of age in his mother's arms.