Decompression of Fetal Axillary Lymphangioma to Prevent Dystocia

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Abstract
Lymphangiomas are commonly diagnosed by prenatal ultrasound. These anomalies are most often cervical, but occasionally present in the axilla, thorax and abdomen. We present a case in which intrauterine drainage was followed by an uneventful vaginal delivery. A 30-year-old G4P3 female was referred to our ultrasound unit at 36 weeks of gestation for evaluation of a large cystic chest wall mass. Ultrasound demonstrated a large septated mass along the left chest wall up to the apex of the axilla of the fetus. The left arm was held in 90 degrees abduction due to the mass. Because of concern about shoulder dystocia at delivery the cystic mass was aspirated under ultrasound guidance and the patient underwent an uneventful induction of labor. Intrauterine decompression of large axillary lymphangiomas may obviate concern about a shoulder dystocia and avoid the need for cesarean sections.

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