Etiology and prognosis of severe ventriculomegaly diagnosed at late gestation.
File(s)
Accepted version
Author(s)
Dall'Asta, Andrea
van Oostrum, Noortje Hm
Basheer, Sheikh Nigel
Paramasivam, Gowrishankar
Ghi, Tullio
Type
Journal Article
Abstract
OBJECTIVES: We sought to assess the causes and outcomes of severe VM diagnosed de novo after 24 weeks of gestation where a mid-trimester anomaly scan was described as normal. METHODS: Multicenter retrospective study of five European fetal medicine centers. The inclusion criteria were normal anatomy at the mid-trimester scan, uni/bilateral finding of posterior ventricle measuring ≥ 15 mm after 24 weeks with neonatal and postnatal pediatric and/or neurological assessment data. RESULTS: Of 74 potentially eligible cases, 10 underwent termination, the outcome was missing in 19 cases and there was 1 neonatal death. Therefore, 44 formed the study cohort with a median gestation at diagnosis of 32 + 0 weeks (25 + 6 - 40 + 5). VM was unilateral in five cases. Agenesis of the corpus callosum (ACC) and grade III/IV intraventricular hemorrhage (IVH) accounted for 14 cases each. ACC was isolated in 9 fetuses. Obstructive abnormalities included 5 arachnoid and 1 cavum velum interpositum cyst. Four fetuses had an associated suspected or confirmed genetic condition, 2 congenital infections, 1 abnormal cortical development and the etiology was unknown in 3/44. Postnatal assessment at median 20 months (3 - 96) showed 22/44 (50 %) normal, 7 (16 %) mildly abnormal and 15 (34 %) severely abnormal neurodevelopmental outcomes. CONCLUSION: One half of babies with severe VM diagnosed after 24 weeks have normal infant outcome with ACC and IVH representing the most common causes. Etiology is the most important factor affecting the prognosis of fetuses with severe VM diagnosed at late gestation.
Date Issued
2018-07-05
Date Acceptance
2018-04-16
Citation
European Journal of Ultrasound / Ultraschall in der Medizin, 2018, 39, pp.675-689
ISSN
0172-4614
Publisher
Thieme Publishing
Start Page
675
End Page
689
Journal / Book Title
European Journal of Ultrasound / Ultraschall in der Medizin
Volume
39
Copyright Statement
© 2018 Georg Thieme Verlag KG Stuttgart.
Identifier
https://www.ncbi.nlm.nih.gov/pubmed/29975968
Subjects
Science & Technology
Technology
Life Sciences & Biomedicine
Acoustics
Radiology, Nuclear Medicine & Medical Imaging
fetal neurosonography
central nervous system
antenatal ultrasound
third-trimester scan
FETAL
BRAIN
EPIDEMIOLOGY
GUIDELINES
FETUSES
SIGN
Agenesis of Corpus Callosum
Child
Female
Humans
Hydrocephalus
Infant, Newborn
Pregnancy
Prognosis
Retrospective Studies
Ultrasonography, Prenatal
Humans
Hydrocephalus
Ultrasonography, Prenatal
Prognosis
Retrospective Studies
Pregnancy
Child
Infant, Newborn
Female
Agenesis of Corpus Callosum
Nuclear Medicine & Medical Imaging
Publication Status
Published
Coverage Spatial
Germany
Date Publish Online
2018-07-05