Prognostic Features and Long-Term Outcome in Patients with Isolated Fetal Ventriculomegaly

Abstract

Objective: In order to provide aid for prenatal counseling in fetal isolated ventriculomegaly (IVM) on ultrasound, we recorded the latest long-term clinical and imaging outcomes of children with a mean age of 7.2 years (range 2.1-14.6). Methods: In 72 fetuses with IVM, diagnosed between 1999 and 2011, the measurement quality of atrial diameter was reviewed in the axial plane. We assessed the association of characteristics of IVM with outcome parameters in the cohort and in subgroups. Prognostic values of significant associations were reported by receiver operating characteristic curve analysis. Results: Cerebral anomalies were diagnosed postnatally in 42% and genetic disorders in 12% of 45 live births. Significant associations of outcome parameters were found between the degree of IVM and genetic disorders (p = 0.017) with an area under the curve (AUC) of 0.866, and between progression of IVM and motor impairment (p = 0.024) with an AUC of 0.789. No significant correlation was found with the other assessed outcome parameters. Furthermore, our subgroup analysis clearly showed that, if cerebral or genetic anomalies are not found postnatally, a favorable outcome may be expected. Discussion: Diameter and progression in IVM are not significantly associated with most outcome parameters. Cerebral anomalies and genetic disorders may contribute to an unfavorable outcome.

Antenatal counselling for prospective parents whose fetus has a neurological anomaly: part 2, risks of adverse outcome in common anomalies

“…• Counselling for myelomeningocele should involve a multidisciplinary team with knowledge of all long-term outcomes. 12mm, [22][23][24]26 and our view is that the term 'moderate ventriculomegaly' can cause unnecessary anxiety and should be abandoned. Unilateral ventriculomegaly (one ventricle is >10mm and ≥2mm difference between the size of the lateral ventricles) and asymmetrical ventriculomegaly (both lateral ventricles >10mm, but ≥2mm difference between sides) have similar outcomes to bilateral ventriculomegaly.…”

“…22,36 The rates of ventriculoperitoneal shunt insertion (VPS) were 21.4% to 29.5%. 26,37 Larger and progressive ventriculomegaly are the most likely to require neurosurgical intervention and usually have an adverse developmental outcome. 31…”

“…Of the surviving infants, developmental outcome was typical in 42.4%, mild/moderate atypical outcomes in 18% to 30% (defined as developmental scores 1–2SD below the mean), and severely atypical in 30% to 40% 22,36 . The rates of ventriculoperitoneal shunt insertion (VPS) were 21.4% to 29.5% 26,37 . Larger and progressive ventriculomegaly are the most likely to require neurosurgical intervention and usually have an adverse developmental outcome 31 …”

Clinical Characteristics and Prediction of Neurodevelopmental Outcomes for Infants with Ventriculomegaly in Utero: A Prospective Observational Study

“…In addition, previous literature has identi ed the presence of associated anomalies is the main determinant of neurodevelopmental outcomes [1,3,8,9]. According to most studies, the presence of other structural CNS and/or non-CNS anomalies signi cantly increases the risk of a poor neurodevelopmental outcome when VM is present [6,7,10,11]. Nevertheless, the study that were included failed to establish a connection between the poor neurodevelopmental outcome and particular CNS or non-CNS anatomical abnormalities.…”

Prognostic Accuracy of Fetal MRI in Predicting Postnatal Neurodevelopmental Outcome

“…Until recently, there have been only scattered studies, limited to mostly studies of cases of isolated ventriculomegaly (VM) and posterior fossa abnormalities, which have assessed the role of feMRI in predicting postnatal outcome. [5][6][7][8] The Magnetic Resonance Imaging to Enhance the Diagnosis of Fetal Developmental Brain Abnormalities in Utero (MERIDIAN) study is a large multicenter prospective study that assessed the utility of feMRI in diagnosing fetal brain abnormalities. 9 One component of this study, published in 2019, assessed the prognostic accuracy of feMRI versus ultrasound in predicting postnatal neurodevelopment.…”