Prenatal ultrasound evaluation of fetal cutaneous hemangioma and related complications

Objectives(cid:0)Congenital hemangiomas are rare benign vascular tumors but can lead to serious adverse pregnancy outcomes. We explored the clinical applications of prenatal ultrasound for evaluating fetal cutaneous hemangioma and associated complications. Methods: A retrospective observational study was conducted comprising a population of pregnant women with fetal cutaneous hemangioma, the latter diagnosed by prenatal ultrasound, between January 2016 and December 2020. The clinical characteristics, sonographic images, complications, and pregnancy outcomes were documented and analyzed. Results: We identi�ed 20 cases of fetal cutaneous hemangioma diagnosed by the prenatal ultrasound and con�rmed by the postpartum examinations. Most hemangiomas were in the head and neck (55%), with either solid isoechoicity (25%) or solid mildly hyperechoicity (25%) and clear boundary (80%). Eight (40%) fetuses were found to have complications, which often occurred in fetuses with large hemangiomas (67% with maximum diameter ≥ 5 cm; 100% with a volume ≥ 40 cm 3 ). The most common complications were cardiac-related (88%), including elevated cardiothoracic area ratio, atrioventricular valve regurgitation, and fetal edema. A large hemangioma was usually associated with advanced gestational age and a fast hemangioma growth rate. In �ve (25%) cases, the pregnancy was terminated; these involved hemangioma of the head or neck. One newborn developed Kasabach-Merritt phenomenon, pulmonary hemorrhage, respiratory distress, and died 3 days after birth. Among the 14 (70%) fetuses that survived birth, all hemangiomas disappeared or regressed after treatments with propranolol, interventional surgery, or routine observations. Conclusions: Prenatal ultrasound examination could accurately diagnose fetal cutaneous hemangioma and related complications to facilitate appropriate management during the pregnancy.