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Management of Dystocia Caused By a Large Sacrococcygeal Teratoma

From the Departments of Pediatrics and of Obstetrics and Gynecology. University of Medicine and Dentistry of New jersey-New Jersey School of Osteopathic Medicine and the Kennedy Memorial Hospital-University Medical Center, Stratford, New Jersey; and the Department of Obstetrics/Gynecology, Ohio University-College of Osteopathic Medicine and Grandview Hospital, Dayton, Ohio.

Sacrococcygeal teratoma is a rare cause of dystocia. Reported management strategies to date have yielded few viable infants. In this case report, the infant was partially delivered when extraction was halted. The infant was intubated and resuscitated while preparations for emergency cesarean section were being made. The infant was subsequently delivered abdominally and three years later is normal. Despite absent thoracic cage movement during resuscitation, adequate oxygenation was possible. Increasing use of prenatal ultrasonography should allow early detection, and thus avoid such unanticipated dystocias.

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