ArticlePrenatal diagnosis2026
Maternal Sirolimus Therapy for Fetal Extensive Lymphatic Cystic Malformation: Selection Criteria, Management, and Outcomes in a Series of Six Cases.
Article in Prenatal diagnosis, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
2 citing papers in PubMed.
- Maternal Sirolimus Therapy for Fetal Extensive Lymphatic Cystic Malformation: Selection Criteria, Management, and Outcomes in a Series of Six Cases.Prenatal diagnosis · 2026Article
- Prenatal Diagnosis and Management of Kaposiform Hemangioendothelioma With Kasabach-Merritt Phenomenon: Imaging Features and First Experience With Maternal Sirolimus Therapy.Prenatal diagnosis · 2026Article
Corrections and comments
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Authors and funding
16 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveMaternal sirolimus therapy has emerged as a potential prenatal treatment for extensive fetal lymphatic malformations, particularly when associated with the risk of neonatal airway compromise. Data on prenatal indications, pharmacokinetics, and outcomes remain limited. We aimed to describe patient selection, treatment management, maternal and fetal safety, and early outcomes.
methodsBetween December 2023 and May 2025, 15 fetuses with extensive cystic or mixed vascular anomalies suggestive of lymphatic malformations were referred to a national reference center. Prenatal ultrasound and fetal magnetic resonance imaging were performed. After maternal evaluation and informed consent, sirolimus was administered with weekly dose adjustments based on maternal trough levels. Tolerance, drug concentrations at delivery, obstetric outcomes, and neonatal evolution were assessed. Decrease in lesion extent was assessed using a semi-quantitative 0-4 imaging scale.
resultsSix fetuses received therapy after the exclusion of nine cases. Treatment began between 24 and over 30 weeks' gestation. Maternal adverse effects were mild. Transplacental drug transfer was observed with variable maternal-fetal ratios. Mean gestational age at birth was 38.1 weeks. Partial or marked lesion regression occurred in five newborns.
conclusionsMaternal sirolimus therapy appears feasible and well tolerated for extensive fetal lymphatic malformations, demonstrating transplacental transfer and encouraging early perinatal outcomes in carefully selected pregnancies overall.
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