Fetal cerebral ventriculomegaly: outcome in 176 cases

Abstract

ABSTRACT

The significance of fetal ventriculomegaly: etiology, short‐ and long‐term outcomes

“…Malformations are more often found in cases of severe VM (Romero et al, 1988;Den Hollander et al, 1998). We have recently reported that 60% of 60 severe VM had an associated anomaly, the most common ones being ACC and spina bifida; however, non-CNS malformations accounted for almost 1/3 of detected anomalies (Gaglioti et al, 2005). Two other recent studies report on the outcomes of severe VM: Breeze et al (2007) found that 65% of the cases (13/20) had associated malformations, almost half of them being ACC.…”

“…The low sensitivity before 24 weeks probably reflects the natural history of the disease, and not a measurement error, because severe VM is easily detectable, even on a qualitative basis: CSF accumulates in the ventricular system over time and VM becomes evident only later in gestation. In a recent study, only 57% of 60 cases of severe VM were diagnosed before 24 weeks of gestational age (Gaglioti et al, 2005). Diagnostic accuracy is affected by measurement variability.…”

“…VM is severe when the measurement of the ventricular width is >15 mm, or ≥15 mm according to different authors (Den Hollander et al, 1998;Graham et al, 2001;Gaglioti et al, 2005;Breeze et al, 2007); it is defined mild or borderline when the measurement is less (Wax et al, 2003;Wyldes and Watkinson, 2004). Recent data would suggest to further divide borderline VM into mild (10-12 mm) and moderate (>12-15 mm) (Signorelli et al, 2004;Gaglioti et al, 2005;Salomon et al, 2006;Falip et al, 2007).…”

“…ultrasound examinations, screening for infections, eventually magnetic resonance imaging (MRI) and potentially dangerous procedures (amniocentesis), which underscores the importance of avoiding measurement errors. Other false positive prenatal diagnoses could be due to the regression of VM during fetal life in some cases (Gaglioti et al, 2005;Falip et al, 2007;Parilla et al, 2006) or to measurement variability, as discussed below. No data are available regarding false negative diagnoses of borderline VM.…”

“…These data could represent an underestimation of the true rate, since both reports describe cases referred for apparently isolated VM. Data on the rate of structural malformations associated with borderline VM vary widely, from 10 to 76% (Goldstein et al, 1990;Bromley et al, 1991;Patel et al, 1994;Vergani et al, 1998;Pilu et al, 1999;Mercier et al, 2001;Gaglioti et al, 2005;Breeze et al, 2005;Morris et al, 2007) (Table 2).…”