Fetal ventriculomegalies during pregnancy course, outcome, and psychomotor development of born children

Abstract

Malformations of the central nervous system are the most complicated and the most common congenital disorder with a prevalence of one in 100 to one in 500 newborns. Regular ultrasound examinations are the most important aspect of detecting these anomalies [1]. The etiology of the disease is variable and can be genetic (chromosomal abnormalities), secondary (as a consequence of intracranial hemorrhage, hypoxic-ischemic lesions, transplacental infection, obstruction of the flow of cerebrospinal fluid) or multifactorial [2,3].Ventriculomegaly is defined as an ventricular increase regardless of the degree and etiology of enlargement. Hydrocephalus refers to a heavier degree of ventriculomegaly. Transverse diameter (width) of atrium measurement is the most widely accepted method for ultrasound evaluation of the size of the lateral ventricles of the brain. It is measured at the level of choroid plexus glomus. Ventriculomegaly is divided according to the degree of enlargement in mild (10-12 mm), moderate (13-15 mm), and severe (> 15 mm). The term 'borderline' includes mild and moderate ventriculomegaly and represent 'gray zone', because the authors do not agree that it is real ventriculomegaly or just a phase in the normal development of the cerebral ventricles [4][5][6]. In the case of diagnosis of borderline ventriculomegaly, sometimes it is difficult to make a final decision on the further course of pregnancy and advise parents. Mild ventriculomegaly frequently affects both lateral ventricles, and it can also be unilateral or asymmetric [7]. Isolated ventriculomegaly is defined as a ventricular enlargement with normal intraventricular pressure, which is not associated with other sonoFigureic abnormalities of the central nervous system and accounts for 20% of sonoFigureically detected fetal ventriculomegaly. It is considered a dynamic process, so that from the moment of diagnosis until the end of pregnancy may cause spontaneous regression, but also can progress to a severe form [8,9].The objectives of this study were as follows: to present the course and outcome of pregnancies complicated with fetal ventriculomegaly, determine the association between prenatal ultrasound diagnoses and definitive postnatal diagnosis or diagnoses after autopsy and additional analysis, and to monitor the psychomotor development of children born with ventriculomegaly. Materials and Methods Time and place of study implementationThe research was conducted at the Department of Gynecology and Obstetrics, Clinical center of Serbia in the period from January 2002 until December 2012. Respondents -monitoring unitsThe study included 62 pregnant women who were attending a regular ultrasound examinations at the Department of Gynecology and Obstetrics, Clinical Center of Serbia, or patients who were re-