Description:
This guidance has considered the following types of fetal tumours: sacrococcygeal teratomas, cervical teratomas, cystic hygromas and congenital cystic adenomatoid malformations (CCAM). These tumours are usually benign, although teratomas may also be malignant. The tumours can become very large and highly vascularised, causing stress on the fetal heart, leading to the development of heart failure. Fetal mortality is high and a poor prognosis is associated with non-immune hydrops fetalis, placentomegaly, cardiomegaly, large tumour size and high tumour growth rate.
Percutaneous laser therapy for fetal tumours involves using laser energy to destroy tumour tissues and to coagulate blood vessels within the tumour. The procedure is performed under maternal local anaesthesia and light sedation by inserting a needle into the uterine cavity through the mother's abdomen under ultrasonographic guidance. An analgesic is then injected subcutaneously or intramuscularly into the fetus before advancing the needle to the site of the fetal tumour. Colour-Doppler imaging is used to guide placement of the needle. A laser fibre is passed through the needle lumen and laser energy is then delivered in pulses causing destruction of tumour tissues and coagulation of blood vessels within the tumour.
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