Background Mild Isolated Ventriculomegaly affects 0.15–0.7% of pregnancies.¹ The developmental prognosis for children seems to be better than that described for ventriculomegaly associated with other anomalies.² But the risk of developmental delay is still unclear and presents a challenge to physicians for managing and counselling prospective parents.

Aim To evaluate the prenatal management and prognosis of isolated mild cerebral ventriculomegaly. This is the first study on ventriculomegaly in Wales.

Methods 63 cases of ventriculomegaly were reported from the healthboard to CARIS database with Hydrocephalus during 2003–2012. 35 were identified as isolated mild ventriculomegaly. 30 case notes were reviewed as 5 case notes could not be traced. Of the 30, 3 were lost to follow-up as they moved out of the area.

Results 28 cases were diagnosed at second trimester anomaly scan, while one patient booked late at 28 weeks and in another the scan was normal at anomaly but developed later. 100% of women were screened for TORCH infection, all were negative for current infections. All women were offered amniocentesis, 9(30%) of them accepted, all 9 (30%) were normal karyotype. All women had scans every 4 weeks. Two women underwent termination due to progression of ventriculomegaly. In 17 (63%) cases of ventriculomegaly resolved in third trimester, it is difficult to asses the prognosis of these babies as they did not have cranial ultrasound or neurodevelopmental assessment routinely.

Conclusions In our study all routine investigations including TORCH and karyotype are normal. 63% of the cases of mild isolated ventriculomegaly resolved in utero. It has highlighted the lack of uniform policy in neonatal assessment. There are limitations including the retrospective model, small sample size and not having the neonatal follow up.

References

1. Wax JR, Bookman BS, Cartin A, Pinette MG, Blackstone DO. Mild fetal cerebral ventriculomegaly: diagnosis, clinical associations and outcomes. Obstet and Gynaecol survey. 2003; 58(6):407–414

2. Mercier A, Eurin D, Mercier PY, Verspyck E, Marpeau L, Marret S. Isolated mild fetal cerebral ventriculomegaly: a retrospective analysis of 26 cases. Prenat Diagnosis 2001;21:589–595

3. Pilu G, Falco P, Gabrielli S, Perolo A, Sandri F, Bovicelli L. The clinical significance of fetal isolated cerebral borderline ventriculomegaly: report of 31 cases and review of literature. Ultrasound Obstet Gynecol. 1999;14:320–6