Evaluation of pregnancy and delivery in 13 women who underwent resection of a sacrococcygeal teratoma during early childhood.

Marijke Eb Kremer,Marc Hwa Wijnen,Ernest Lw Van Heurn,Audrey Coumans,Hugo A Heij,René Mh Wijnen,Joep Pm Derikx,Robertine Van Baren,Margot M Koeneman,David C Van Der Zee

doi:10.1186/s12884-014-0407-x

Abstract

BackgroundSacrococcygeal teratoma resection often brings changes in pelvic anatomy and physiology with possible consequences for defecation, micturition and sexual function. It is unknown, whether these changes have any gynecological and obstetric sequelae. Until now four pregnancies after sacrococcygeal teratoma resection have been described and cesarean section has been suggested to be the method of choice for delivery. We evaluated the pregnancy course and mode of delivery in women previously treated for a sacrococcygeal teratoma.MethodsThe records of all patients who underwent sacrococcygeal teratoma resection after 1970 in one of the six pediatric surgical centers in the Netherlands were reviewed retrospectively. Women aged 18 years and older were eligible for participation. Patient characteristics, details about the performed operation and tumor histology were retrieved from the records. Consenting participants completed a questionnaire addressing fertility, pregnancy and delivery details.ResultsEighty-nine women were eligible for participation; 20 could not be traced. Informed consent was received from 41, of whom 38 returned the completed questionnaire (92.7%). Thirteen of these 38 women conceived, all but one spontaneously. In total 20 infants were born, 17 by vaginal delivery and 3 by cesarean section, in one necessitated by previous intra-abdominal surgery as a consequence of sacrococcygeal teratoma resection. Conversion to a cesarean section was never necessary. None of the 25 women without offspring reported involuntary childlessness.ConclusionsThere are no indications that resection of a sacrococcygeal teratoma in female patients is associated with reduced fertility: spontaneous pregnancy is possible and vaginal delivery is safe for mother and child, irrespective of the sacrococcygeal teratoma classification or tumor histology.

Highlights

Sacrococcygeal teratoma resection often brings changes in pelvic anatomy and physiology with possible consequences for defecation, micturition and sexual function
There is iatrogenic damage of the pelvic anatomy as in almost all cases the tumor is completely resected together with the coccyx and several perineal and pelvic muscles are fully or partly resected [8]. In women this may lead to pelvic functional changes such as organ prolapse [11]. It is unknown if the changes of the female pelvic anatomy and function, which may result in alteration of the birth channel, influence fertility, pregnancy and delivery
The present study evaluates pregnancy and delivery in a cohort of 13 women who underwent Sacrococcygeal teratoma (SCT) surgery during childhood

Summary

Introduction

Sacrococcygeal teratoma resection often brings changes in pelvic anatomy and physiology with possible consequences for defecation, micturition and sexual function. It is unknown, whether these changes have any gynecological and obstetric sequelae. Until now four pregnancies after sacrococcygeal teratoma resection have been described and cesarean section has been suggested to be the method of choice for delivery. There is iatrogenic damage of the pelvic anatomy as in almost all cases the tumor is completely resected together with the coccyx and several perineal and pelvic muscles are fully or partly resected [8] In women this may lead to pelvic functional changes such as organ prolapse [11]. Others reported an uncomplicated spontaneous vaginal delivery of a healthy term baby [14]

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