Prenatal Diagnosis and Management of a Fetal Thyroid Teratoma: A Multidisciplinary Approach with an EXIT Procedure

Index, 3.55 mm was identified as the cut off for abnormal cell free DNA screening with a sensitivity 73.6%, specificity 53.6%, and an AUC 0.652 [0.570-0.735](p < 0.001).Patients were then stratified with 140 (60%) patients with NT 3.55 mm and 93 (40%) with NT < 3.55 mm.Patient information and outcomes were extracted and Chi-squared, and Mann-Whitney U test analysis were performed.Results: Groups were similar in age, insurance status, race, parity, maternal co-morbidities, and pregnancy-induced hypertension.Patients with an NT 3.55 mm were more likely to use tobacco products (7% v 0%, p = 0.01) and have a lower BMI (26 v 28, p = 0.02).Patients with an NT 3.55 mm were more likely to have abnormal cell free DNA screening compared to an NT < 3.55 mm (47% v 23%, p < 0.001).Patients with an NT 3.55 mm were more likely have structural anomalies (59% v 32%, p < 0.01); however, incidence of cardiac malformations was similar.Those with an NT 3.55 mm was more likely to have invasive testing performed (54% v 31%, p < 0.01).Results with abnormal karyotypes similar across groups (56 v 54%, p = 1.00); however, the NT < 3.55 mm group was more likely to have abnormal microarray (58% v 32%, p = 0.05).Birth outcomes including gestational age at delivery, birth weight, Apgar scores, NICU admission, and postpartum hemorrhage were similar across groups.Conclusions: Patients with NT measurement greater than or equal to 3.5 mm on ultrasound between 11-14 weeks gestation were more likely to have positive screening cell-free DNA results, as well as structural anomalies.