Perinatal outcomes with the antepartum diagnosis of cystic hygroma.

OBJECTIVE: To describe antenatal diagnosis and clinical outcomes of fetal cystic hygroma. STUDY DESIGN: Retrospective case series derived from ultrasound database. Diagnoses were made from July 2000 through January 2003. RESULTS: Twenty-five fetuses were identified with cystic hygroma. Median gestational age at diagnosis was 17.3 weeks. Posterior nuchal cystic hygromas accounted for 21 (84%) cases, while two (8%) were axillary, and one each in the anterior neck and buttock. Additional abnormalities were noted in twenty (80%) fetuses; most common were non-immune hydrops (12/25, 48%) and cardiac defects (5/25, 20%). Eighteen patients (72%) underwent amniocentesis and ten were aneuploid. Six fetuses (25%) sustained intrauterine fetal demise and nine (38%) patients sought therapeutic termination. Nine infants (38%) were liveborn, but only six (25%) survived the neonatal period. CONCLUSIONS: Antenatal diagnosis of fetal cystic hygroma heralds an extremely poor perinatal prognosis. Associated abnormalities were noted in 80% of fetuses with a significant incidence of aneuploidy. Targeted ultrasonography and extensive counseling of parents is recommended.