A sacrococcygeal teratoma (SCT) is a rare tumor that can grow near a baby's tailbone. It is usually not cancerous, and doctors can usually remove it and the baby will be OK.

Fetal surgery for SCT may be required if an unborn child develops life-threatening complications.

Large SCTs that are solid and have many blood vessels can be a risk to the baby and the pregnancy. The baby’s heart has to pump blood to support both its body and the blood vessels in the tumor. This makes the heart work much harder than normal. If the fetus’s heart can’t keep up, fetal hydrops may develop. Fetal hydrops is fluid accumulation in the chest, abdomen, scalp or skin.

Hydrops can cause heart failure in the fetus. It can also impact the mother's health. The mother may “mirror” the symptoms of the baby. We call this maternal mirror syndrome. Symptoms can include swelling and dangerous blood pressure changes.

If your unborn baby with SCT develops fetal hydrops and the condition puts them at risk, immediate care is needed. If your fetus is at full term, we will perform an emergency cesarean section. If they are not ready to be born, fetal surgery to remove the SCT will be required.

What to expect during fetal surgery to remove an SCT

Fetal surgery to remove an SCT involves a highly skilled team. You will receive general anesthesia. This will give you complete pain relief. While general anesthesia will also ease most of the pain of the fetus, additional anesthesia is given to your baby directly during the operation.

Once you are asleep, your fetal surgeon will make an incision similar to that of a cesarean section and will lift the uterus partly out of the abdomen. This procedure is called a hysterotomy. Next, the surgical team will open the uterus and expose your baby's tumor. Your fetal surgeon will remove the tumor and close the wound in your baby's back. The uterus is then closed, placed back inside your abdomen and the abdominal incision is repaired. Mothers recover in the hospital for several days.

At Children's Hospital of Philadelphia (CHOP), all of your care takes place in the same space. This includes fetal surgery, your baby’s delivery and postnatal care for both of you. After fetal surgery, you will stay in our Garbose Family Special Delivery Unit (SDU). This is the world’s first birth facility designed exclusively for pregnancies complicated by birth defects.