^{Intrapericardial teratoma is rare prenatal condition. A diagnosis is based on the observation of intrapericardial heterogenous mass accompanied by pericardial effusion. It is the second most frequent primitive cardiac tumor in neonate and is usually benign. It may lead prenatally to rapid hydrops progression with cardiac tamponade and lung compression. We present a prenatal intervention using the first successful pericardio-amniotic drainage. Case report: Teratoma 35x25 mm accompanied by a large pericardial effusion was diagnosed at 28 weeks of gestation. Our strategy was to avoid cardiac tamponade and possible pulmonary hypoplasia using pericardio-amniotic shunting. The procedure was performed together with amniodrainage contributing to a delay in delivery. That procedure led to significant decrease of pericardial effusion and expansion of lungs. Cardiothoracic index dropped from 0,67 to 0,47. After 10 days, however, the shunt was released from pericardial sac to pleura. Pericardial effusion gradually increased, size of teratoma progressively extended to 50x45mm and compressed right atrium and superior vena cava. Neonate was delivered in 33rd week of gestation by Caesarean section. The surgery was performed within 6 hours in a baby without haemodynamic compromise. The tumor arising from the ascending aorta was carefully dissected and histology confirmed diagnosis of intrapericardial immature teratoma. The recovery was uneventful and at 6 month the baby is healthy. Conclusion: Pericardio-amniotic shunt seems to be a promising treatment option in fetuses with large pericardial effusion to prevent endouterine death and/or severe respiratory distress in neonates. Supported by grants – NR9451-3/2007 and MZO-00064203}