OB-45 : A Case of Second Trimester Cystic Hygroma and Clinical Management

Cystic hygroma (CH) is a congenital malformation of the lymphatic system characterized by single or multiple cystic masses that are mostly located around the neck. The prognosis depends upon the time of detection, associated chromosomal anomaly, and size of the mass. We present a case report of the CH that was detected at 25 week`s gestation on second-trimester sonography. A 31-year-old primigravida was referred to our hospital at 25 weeks plus 2 days` gestation for a fetal neck mass. 2D USG showed 3.0 cm × 2.0 cm sized CH located anterolaterally on left side of fetal neck. No other congenital anomaly was seen sonographically. During serial flow up, the size of the CH was increased to 4.9 cm ⅹ 3.9 cm at 37 weeks plus 4 days` gestation. At 39 weeks plus 1 day gestation, the patient was admitted due to rupture of membranes, and spontaneous labor began. However, an emergency cesarean section was performed due to non reassuring fetal heart rate, at 39 weeks plus 2 day gestation. The baby was male, and his weight was 2968g. The Apgar scores were 7/8. The baby was admitted to the neonatal intensive care unit. Postnatal neck USG and MRI scan showed 6 × 6.3 × 5.8 cm, huge cystic mass in the left submandibular space extending to masseter and parapharyngeal spaces. In addition, airway was deviated to the right, from oropharynx to subglottic level. After two treatments of sclerotherapy, the size of the CH was decreased, and only some residual fluid collection was remained. The baby was discharge 29 days after admission without serious complications and other congenital anomalies