Prognosis and management When the initial diagnosis of sacrococcygeal teratoma is made, a careful ultrasound examination should be carried out to exclude associated anomalies. Following this, the fetus should be monitored regularly during pregnancy to assess tumour growth and to detect the development of polyhydramnios or fetal hydrops. The majority of fetuses with sacrococcygeal teratoma have a good outcome following surgery in the neonatal period. Most authors advise elective caesarean section if the tumour is large (Fig. 7.28) to avoid the complications of distocia and possible damage to the tumour, which can lead to haemor- rhage and neonatal complications. 41 A small proportion of tumours are rapidly growing and progress to hydrops, polyhydramnios and fetal demise 55,156 addition, the fetal hydrops In may also precipitate a pre-eclampsia-type condition in the mother with symptoms of vomiting, hypertension, peripheral and pulmonary oedema. This condition is similar to the 'mirror syndrome' previously described in Rhesus disease, in which the status of the mother begins to mirror' the condition of the fetus In this condition, premature delivery of the fetus may be necessary for maternal indications 156 As the outcome for this group of fetuses is so poor, certain groups have advocated either open