Cystic hygroma is a congenital pathology of the lymphatic system, which begins to develop even in utero - just like Collins syndrome. Occurs in different parts of the body, but, as a rule, is localized in the head and neck of the fetus.
What are the causes of cystic hygroma of the fetal neck? What is she fraught with? Is it really possible to eliminate it? This and many other things will be discussed now.
About pathology
Cystic hygroma is a neoplasm consisting of cysts that differ in size. It is dangerous for the embryo, because it can lead to death. If a child is born, then he is assigned an emergency surgical intervention to remove the neoplasm.
The tumor is benign, visually resembles a bag. It is in it that the cysts are concentrated. They can be of different sizes - from 1 mm to 5 cm. Mucus and serous fluid accumulate inside them.
Children with this pathology have certain problems withhe alth. The following immediately come to light:
- Paresis of the facial nerve.
- Curvature of the lower jaw and spine.
- Violation of the swallowing reflex.
- Curvature of the bone at the back of the head.
- Difficulty breathing.
Cystic hygroma of the neck is an isolated neoplasm, but sometimes fluid from the cysts enters the soft tissues that surround it. This composition may be in the fiber, under the skin.
It should also be noted that the tumor can occur both on one side of the neck, and on both. In rare cases, it appears in other places, occupying a fairly large area.
Reason
The substrate of the cystic hygroma of the fetal neck is dilated lymphatic vessels. It is they who form a network, which later transforms into a cyst filled with serous fluid. Why does she appear? It's simple: lymph drainage into the venous system is disturbed, anomalies in the structure of blood vessels and their valves occur.
But why does cystic hygroma of the neck form? What are the precipitating factors? Unfortunately, for some women, the risk of developing this pathology in the fetus is quite high. Hygroma can develop if one of the following factors occurs:
- Presence of infectious diseases.
- Injuries.
- Bad habits.
- Heredity.
- Using certain medications.
Also, do not forget about external influences. It is especially unfavorable in the firsttrimester - during the period when the main systems of the body are hardened. If a woman at that time had a viral infection or was taking some toxic medication, then there is a risk of having a baby with cystic hygroma of the neck.
It is important to mention that often defects in the structure of the lymphatic system are formed in children with chromosomal abnormalities. For example, Turner, Down, Patau, Klinefelter, Noonan, Roberts and Edwards syndromes. Often there is brain dysplasia.
Considering all of the above, hygroma is an important indicator of fetal he alth. Chromosomal abnormalities can not always be determined, but we must not forget that other negative processes often occur in the body of the embryo. That is why a woman carrying a fetus must definitely undergo routine examinations.
Classification
She also needs attention. The causes of cystic hygroma of the fetal neck were discussed above, now we need to talk about what types of neoplasms exist. The following are distinguished:
- Cavernous. It is formed from large vessels that are covered with a serous membrane.
- Simple. Such a tumor is formed from capillaries.
- Cystic. As already mentioned, it consists of cavities (one or more).
The last type occurs most often in embryos at the time of intrauterine development. It is important to note that the tumor loses contact with the lymphatic system, becomes rather isolated.
It has already been said that a neoplasm may appear in other parts of the fetus. Often formed retroperitoneal, mediastinal, inguinal, axillary hygroma. They can be either isolated or multiple. It already depends on which parts of the lymphatic system are experiencing the most changes.
Symptoms
It has already been said above about the causes of cystic hygroma of the neck. It is important to discuss the symptoms as well. In fact, the vast majority of neoplasms occur without any manifestations in the antenatal period.
A woman carrying a fetus does not feel any extraneous signs that cause anxiety. Her condition is determined by physiological changes in the body, as well as the gestational age. Only on the basis of the results of an instrumental examination, it is possible to determine the presence of the discussed pathology in the fetus.
Unfortunately, cystic hygroma is most often detected after the birth of a child. In the first two years of his life, to be precise. Then already the pathology makes itself felt. The tumor gradually grows, the skin over it becomes a bluish tint.
Such a neoplasm is quite capable of squeezing the surrounding organs. This is already felt by the child directly. Such complications are dangerous, because vital structures are concentrated in the neck area. These are nerves, vessels, parts of the digestive and respiratory systems. There is a real risk to the he alth and life of the child. You should also be alert if one of the following symptoms is observed:
- Rapid, noisy breathing.
- Stop breathing during sleep.
- Violationswallowing.
By the way, because of the latter, there are often problems with feeding. And because the newborn is very poorly gaining weight. Subsequently, it becomes noticeable that he is far behind his peers.
If the hygroma exists for a long time, bone structures begin to deform. Processes affect the occipital bone, jaw, cervical spine.
If a tumor is accompanied by any genetic disease with chromosomal abnormalities, then multiple developmental defects can be noticed. However, even with an absolutely normal karyotype, there is a risk of malformations of the lungs, kidneys and heart. It is important to know that intrauterine dropsy of the fetus is often associated with hygroma.
Forecasts and risks
Based on all of the above, we can understand that this is cystic hygroma of the fetus. The pathology is serious, and therefore it is necessary to discuss the possible risks arising from it.
Unfortunately, most cases end badly. The fetus dies in the second or first trimester. The reason is gross malformations that are incompatible with life. In other cases, the issue of the need to terminate the pregnancy is resolved. Especially if it was possible to identify a chromosomal abnormality.
Is a favorable forecast possible? Yes, if the karyotype is not changed, and treatment is started in a timely manner. If the fetus has developed a small cystic hygroma, then the woman will be able to give birth to him on her own.
But since there is a high risk of other anomalies forming, it will be necessary not only to remove the tumor. Troubleshooting is a must. Otherwise, the hygroma will increase. Even a previous infection can lead to this.
However, it also happens that the cystic hygroma of the neck, the photo of which is unpleasant, disappears on its own. Such cases are associated with the resumption of lymph circulation, which occurs spontaneously. The fluid is drained from the sac into the venous system, the state of he alth improves. If this happens, then the forecast is more favorable.
Diagnosis
Answering the question of what cystic hygroma of the fetal neck is, this topic also needs to be addressed. Diagnosis is very important. Timely detection of pathology is possible only if a woman undergoes regular examinations. Transvaginal and transabdominal ultrasound are usually sufficient. Thanks to these methods, the following changes can be detected:
- Thin-walled, fluid-filled tumor.
- Increased collar space.
Also, in order to understand whether the fetus has any genetic anomaly, it is necessary to study its chromosome set. You can determine the karyotype by obtaining its cells. However, this is only possible with the use of an invasive method. There are simply no others.
If the doctor considers it necessary, he can prescribe the following diagnostic measures:
- Amniocentesis.
- Chorion biopsy.
- Cordocentesis.
- Placentobiopsy.
Each study listedimplies a puncture. The doctor makes an injection through the abdominal anterior wall. Through this, the material necessary for the diagnosis is selected. They can take cord blood, chorionic villi, amniotic fluid, or placental tissue. The selected material is then subjected to genetic analysis.
If hygroma is detected after the birth of a child, then it becomes necessary to perform additional diagnostics. Be sure to take into account the likelihood of multiple localization of tumors. As a rule, in such cases, an MRI or CT scan is prescribed. Based on the results of these procedures, it is possible to determine the presence of lymphatic tumors in the retroperitoneal space, as well as in the inguinal, axillary zones and in the mediastinum.
Therapy
So, much has been said earlier about what kind of phenomenon the cystic hygroma of the fetal neck is. What to do if such a neoplasm is detected? How to eliminate such a serious and dangerous phenomenon, is it even possible? Well, it is quite possible to improve the situation if the tumor was detected in a timely manner.
The doctor forms an effective treatment strategy, and the patient adheres to it. Pregnancy management directly depends on the results of the diagnosis. An abortion may be recommended for a woman if chromosomal abnormalities and malformations are detected during the diagnosis. In the absence of such complications, she will be able to give birth. And there is also a chance to cure the baby after his birth.
Modern conservative methods of therapy can not only significantly reduce the tumor, butachieve its reverse development. As a rule, a lymphangioma is punctured with further pumping out of the contents, after which medications are injected into the cyst cavity to sclerose its walls. The following means are usually used:
- "Hydrocortisone".
- "Picibanil".
- Ethyl alcohol.
- "Interferon alfa-2a".
- "Bleomycin".
Then, to enhance the effect, the doctor prescribes physiotherapy. The greatest efficiency is shown by UV irradiation of the cervical-collar zone, as well as electrophoresis.
Surgery
How to cure cystic hygroma of the neck, if conservative therapy was powerless? Only through surgery. Doctors strongly recommend it if the tumor begins to grow rapidly and compress surrounding organs.
The simplest option is a simple excision. However, it is also quite risky, because other anatomically important structures are in the immediate vicinity. They can simply be damaged during the operation, and this is fraught with serious consequences.
Because laser coagulation is prescribed. An alternative is also possible - removal of the inner layer of the cystic cavity with its subsequent treatment with sclerosing solutions.
Prevention
If a woman has a genetic predisposition or poor heredity, then it will not be possible to prevent the onset of pathology. Be that as it may, general recommendations must be followed by allpregnant without exception. These include:
- Keeping a he althy lifestyle.
- Proper nutrition, eating he althy foods.
- Lack of strong physical activity.
- Frequent walks and outdoor activities.
In the event that a woman, after the birth of a child, notices strange neoplasms on his neck, she is obliged to take him to a doctor. Self-medication is strictly prohibited.
Reviews
For a woman expecting a baby, learning that her unborn child has cystic hygroma is a real tragedy. However, those girls who have encountered the same problem recommend not to despair. The most important thing is to undergo a thorough examination. Be sure to visit a good medical genetic clinic, where good diagnosticians work, and they also do all the necessary tests.
And of course, we must remember that cases are different. After all, the main thing is a good karyotype. For a woman, if she decides to refuse the doctors' proposal to terminate the pregnancy, it is very important to be at peace and be less nervous. Good outcomes happen, such cases are familiar to medicine.
Some women recommend that both spouses undergo karyotyping before planning pregnancy. This procedure will allow you to understand whether they are genetically he althy. However, there are also such cases that absolutely normal spouses have a child with hygroma and other anomalies. This is called randomness. And after this, he althy children are born to the same parents.
Gygroma –terrible and dangerous pathology. But as it was possible to understand, and it can be de alt with. And this gives some hope.
