Cystic hygroma is a congenital pathology of the lymphatic system that begins to develop in utero - just like Collins syndrome. It occurs in different parts of the body, but, as a rule, it is localized in the head and neck of the fetus.
What are the causes of cystic hygroma of the fetal neck? What is it fraught with? Is it realistic to eliminate it? This and much more will now be discussed.
About pathology
Cystic hygroma is a neoplasm consisting of cysts that differ in size. It is dangerous for the embryo, as it can lead to death. If the child is born, then he is prescribed emergency surgery to remove the neoplasm.
The tumor is benign, visually resembles a bag. It is in it that 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 health problems. The following are immediately identified:
- Paresis of the facial nerve.
- Curvature of the lower jaw and spine.
- Violation of the swallowing reflex.
- Curvature of the bone on 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 appear in 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 vast area.
Cause
The substrate of cystic hygroma of the fetal neck is dilated lymphatic vessels. They form the network, which is subsequently transformed into a cyst filled with serous fluid. Why does she appear? It's simple: the drainage of lymph into the venous system is disrupted, there are abnormalities in the structure of blood vessels, as well as their valves.
But why is cystic neck hygroma formed? What are the triggering 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:
- The presence of infectious diseases.
- Injuries.
- Bad habits.
- Heredity.
- The use of certain medications.
Also do not forget about external influences. It is especially unfavorable in the first trimester - during the period when the basic systems of the body are tempered. If a woman at that time suffered a viral infection or took some toxic drugs, that is, there is a risk of a baby with a cystic hygroma of the neck.
It is important to make a reservation 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.
Given all of the above, hygroma is an important indicator of fetal health. It is not always possible to determine chromosomal abnormalities, but we must not forget that often other negative processes occur in the embryo's body. That is why a woman bearing a fetus must undergo routine examinations.
Classification
It also needs to be addressed. The reasons for the occurrence 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, consists of cavities (one or more).
The latter type is most common in embryos at the time of fetal development. It is important to make a reservation that the tumor loses its connection with the lymphatic system and becomes quite isolated.
It has already been said that a neoplasm can appear in other parts of the fetus. Often retroperitoneal, mediastinal, inguinal, axillary hygroma is formed. They can be either isolated or multiple. It already depends on which particular sections of the lymphatic system are faced with the greatest changes.
Symptoms
We have already said about the causes of cystic neck hygroma. It is important to discuss the symptoms. 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 symptoms that cause anxiety. Her condition is determined by physiological changes in the body, as well as gestational age. Only by the results of 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 more precise. Then already pathology makes itself felt. The tumor gradually grows, the skin above it becomes a bluish tint.
Such a neoplasm is quite capable of compressing the surrounding organs. This is what the child feels directly. Such complications are dangerous, because in the neck area are concentrated vital structures. These are nerves, blood vessels, sections of the digestive and respiratory systems. There is a real risk to the health and life of the child. You should also be alert if one of the following symptoms is observed:
- Rapid, noisy breathing.
- Stop breathing in a dream.
- Violation of swallowing.
By the way, because of the latter, feeding problems often arise. And so the newborn is gaining weight very poorly. Subsequently, it becomes noticeable that he is far behind 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 lung, kidney and heart defects. It is important to know that fetal dropsy is often associated with hygroma.
Forecasts and Risks
Based on everything previously said, we can understand that this is a 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 unfavorably. 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 a pregnancy is resolved. Especially if it was possible to identify a chromosomal abnormality.
Is a favorable prognosis 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 a woman will be able to give birth to it on her own.
But since there is a high risk of the formation of other abnormalities, it will be necessary not only to remove the tumor. Resolving related problems is required. Otherwise, the hygroma will increase. Even an infection can push this.
However, it also happens that the cystic hygroma of the neck, whose photo is unpleasant, disappears on its own. Such cases are associated with the resumption of lymph circulation, which occurs spontaneously. Fluid drains from the sac into the venous system, and health improves. If this happened, then the forecast is more favorable.
Diagnostics
Answering the question of what is cystic hygroma of the fetal neck, this topic also needs to be addressed. Diagnosis is very important. Timely detection of pathology is possible only if the woman regularly undergoes examinations. Usually enough transvaginal and transabdominal ultrasound. Thanks to these methods, it is possible to identify the following changes:
- Thin-walled, tumor-filled mass filled with fluid.
- The increased collar space in thickness.
Still, to understand whether the fetus has any genetic anomaly, it is necessary to study its chromosome set. You can determine the karyotype by getting its cells. However, this is real only using the invasive method. Others simply do not exist.
If the doctor considers it necessary, he can prescribe the passage of the following diagnostic measures:
- Amniocentesis.
- Chorionbiopsy.
- Cordocentesis.
- Placental biopsy.
Each study of the following implies a puncture. The doctor makes an injection through the abdominal front wall. Through this, the material necessary for diagnosis is selected. They can take cord blood, chorionic villi, amniotic fluid, or placental tissue. Then the selected material is subjected to genetic analysis.
If hygroma is detected after the birth of a child, then there is a need to perform additional diagnostics. Be sure to consider the likelihood of multiple localization of tumors. Typically, in such cases, an MRI or CT scan is prescribed. According to 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, a lot has been said about the cystic hygroma of the fetal neck. What to do if such a neoplasm is detected? How to eliminate such a serious and dangerous phenomenon, is it even possible? Well, the situation is quite realistic to improve if the tumor was detected in a timely manner.
The doctor forms an effective therapeutic tactic, and the patient adheres to it. Pregnancy management directly depends on the diagnostic results. A woman may be recommended to have an abortion if during the diagnosis chromosomal abnormalities and malformations are revealed. In the absence of such complications, she will be able to give birth. And there is also a chance to cure the baby after it is born.
Modern conservative methods of therapy can not only significantly reduce the tumor, but also achieve 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 sclerosize its walls. Typically, such means are used:
- Hydrocortisone.
- "Picybanil."
- Ethanol.
- Interferon Alfa-2a.
- "Bleomycin."
Then, to enhance the effect, the doctor prescribes physiotherapy. The highest efficiency is shown by UV radiation of the cervical-collar zone, as well as electrophoresis.
Surgical intervention
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 the surrounding organs.
The simplest option is ordinary excision. However, it is also quite risky, because in the immediate vicinity there are other anatomically important structures. They simply can be damaged during the operation, and this is fraught with serious consequences.
Therefore, 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 work to prevent the appearance of pathology. Be that as it may, general recommendations should be followed by all pregnant women without exception. These include:
- Maintaining a healthy lifestyle.
- Proper nutrition, the use of healthy foods.
- Lack of strong physical exertion.
- Frequent walks and outdoor activities.
In the event that a woman after the birth of a child noticed strange neoplasms on his neck, she must take him to a doctor. Self-medication is strictly prohibited.
Reviews
For a woman expecting a baby, finding out that the unborn baby has a cystic hygroma is a real tragedy. However, those girls who have faced the same problem recommend not to despair. The most important thing is to undergo a thorough examination. Necessarily in a good medical-genetic clinic, where good diagnosticians work, and also do all the necessary tests.
And of course, we must remember that there are different cases. After all, the main thing is a good karyotype. For a woman, if she decided to refuse the doctor’s offer to terminate the pregnancy, it is very important to be calm and less nervous. There are good outcomes, such cases are familiar to medicine.
Some women recommend karyotyping both spouses before planning a pregnancy. This procedure will help to understand whether they are healthy in genetic terms. However, there are such cases that in absolutely normal spouses a child is born with a hygroma and other anomalies. This is called an accident. And after this, the same parents give birth to healthy children.
Hygroma is a terrible and dangerous pathology. But as you could understand, and it can be dealt with. And this gives some hope.