Obstructive congenital epulis: prenatal diagnosis and perinatal management.

OBJECTIVE

To describe a multidisciplinary approach for delivery room management of congenital epulis.

STUDY

DESIGN

Case reports.

METHODS

Reporting of two cases of congenital epulis and review of the literature.

RESULTS

Antepartum ultrasonography demonstrated massive intraoral masses in two fetuses whereby concerns regarding the patency of the airway at birth necessitated development of a multidisciplinary team of maternal-fetal medicine, neonatal-perinatal medicine, anesthesiology, and otolaryngology. Surgical excision was performed before delivery in one infant and after complete delivery in the other without a need for endotracheal intubation and general anesthesia. Feeding was started early, and both infants were discharged after brief hospital stays. Pathological findings were consistent with congenital epulis. Differential diagnosis and options for surgical intervention are discussed, including ex utero intrapartum treatment.

CONCLUSIONS

A multidisciplinary approach to antenatally identified congenital intraoral masses facilitates care at birth. Surgical treatment in this milieu may be simple and complete at the time of delivery.