Article Text

Natural history and outcome of prenatally detected mild cerebral ventriculomegaly from an unselected obstetric population encompassing the northern region of England
  1. F Sethna,
  2. S Robson
  1. Royal Victoria Infirmary, Newcastle, UK

Abstract

Background The prenatal ultrasound finding of mild/moderate ventriculomegaly (VM) (atrial width of lateral ventricles 10–15 mm) presents a counselling dilemma. Large scale population outcome data are lacking. To date studies describing outcomes have investigated relatively small numbers from highly selected referred populations.

Aim To describe the pregnancy outcome of all pregnancies referred with mild/moderate VM between 1994 and 2009 within the former Northern Region (n=822).

Methodology Data were collected from the Northern Congenital Abnormality Survey register and cross-referenced with the fetal medicine database. Outcome information was obtained from paediatric, radiological, histopathology and cytogenetic records.

Results 625 cases were notified. The diagnosis was confirmed at referral scan in 513 cases. Thus in 112 cases either the VM resolved before the referral scan or the initial finding was a false positive. 228 (44%) of confirmed cases had an associated structural anomaly, of which 84 had a neural tube defect. Five cases were associated with fetal growth restriction. In 67 (13%) cases had a chromosomal anomaly and six cases congenital cytomegalovirus infection. These pregnancies were uniformly associated with a poor outcome.

There were 212 cases of isolated VM of which 119 (56%) resolved and 93 (43%) persisted. 17 of these parents opted for termination and 66 had a live birth. Within the resolved group, there was a NND, two infant deaths and one child death.

Conclusion This study highlights the high rate of associated anomalies in mild/moderate VM. The majority of those detected in the second trimester resolve. The neurodevelopmental assessment of the live born children is currently ongoing.

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