Abstract

*Samia Dagdag, Arwa Aboumedian, Nassima Ouguerzi, Hounaida Mahfoud, Samir Bargach

ABSTRACT

Fetal sacrococcygeal teratoma (SCT) is the most common congenital tumor diagnosed in the fetus and neonate. Although frequently benign on histology, prenatal SCT may be associated with severe complications, including polyhydramnios, preterm labor, fetal hydrops, and high-output cardiac failure. We report the case of a 27-year-old gravida 2, para 1 woman referred at 21 weeks of gestation for suspected fetal SCT. Prenatal ultrasound and magnetic resonance imaging confirmed a large predominantly exophytic sacrococcygeal mass. The pregnancy was complicated by progressive polyhydramnios and spontaneous preterm labor at 33 weeks of gestation, leading to cesarean delivery. A live female neonate was delivered, but the tumor ruptured during delivery. Despite neonatal intensive care and surgical excision on the second day of life, the newborn died 48 hours after surgery following postoperative sepsis. This case highlights the potentially severe perinatal course of fetal SCT, particularly when associated with polyhydramnios and preterm labor. Tumor size, vascularity, fetal hemodynamic status, and gestational age at delivery are key prognostic factors. Early diagnosis, close antenatal surveillance, multidisciplinary planning, and prompt postnatal management remain essential to optimize outcomes.