Width of the fetal lateral ventricular atrium between 10 and 12 mm: a simple variation of the norm?

Abstract

Objectives The prognosis of borderline forms of anomalies that can be detected by ultrasound is one of the most challenging issues in prenatal diagnosis. The aim of this study was to determine the prognosis for fetuses presenting with isolated mild ventriculomegaly (MVM). Methods Fetuses in which the width of the lateral ventricular atria was 10–12 mm and which had no other detectable chromosomal or morphological anomalies were followed by monthly ultrasound examinations until delivery. For the cases identified up to December 1997, postnatal information was gathered retrospectively through interviews. Children born from January 1998 onwards were included in a protocol involving planned neuropsychiatric visits at 12 and 18 months of age in which the Griffith scale was used to assess neurodevelopment. Results Between September 1992 and January 2001, 60 fetuses with isolated MVM were identified. Ventricular dilatation diminished in 18 cases (and became normal in nine of these) and stabilized in 42 cases. Information was obtained on 38 children born up to December 1997 and their neurodevelopment was found to be completely normal. The 22 children born from January 1998 onwards showed normal development at 12 and 18 months of age. Conclusions When MVM is observed on prenatal ultrasound examination it can be very difficult to offer parents appropriate counseling. It is important to exclude aneuploidy or morphological abnormalities but even then there will be anxieties about long‐term neurological outcome. Our data, which show normal neurodevelopment between 18 months and 10 years after birth in cases of MVM (10–12 mm), should provide a basis for reassuring counseling. Copyright © 2003 ISUOG. Published by John Wiley & Sons, Ltd.

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

“…Therefore, it is of interest to know the outcome of fetuses with isolated VM. The incidence of perinatal and neonatal death is higher in cases of severe (>15 mm) and moderate (12-15 mm) VM about 25 and 10%, respectively, while it is comparable to that of the general population in cases of mild VM (10-12 mm) (Vergani et al, 1998;Pilu et al, 1999;Graham et al, 2001;Signorelli et al, 2004;Gaglioti et al, 2005). However, the number of cases is too small in order to draw final conclusions.…”

“…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).…”

Natural history of apparently isolated severe fetal ventriculomegaly: perinatal survival and neurodevelopmental outcome

“…Fetuses with isolated mild ventriculomegaly have the most favourable outcomes (Signorelli et al, 2004;Breeze et al, 2005) with a 7-10% risk of learning difficulties (Vergani et al, 1998;Pilu et al, 1999;Gaglioti et al, 2005). There is, however, a lack of outcome data on 'apparently' isolated SVM that can be used to counsel on survival rates and neurodevelopmental outcome.…”

Fetal mild ventriculomegaly: still a challenging problem

“…Mild VM may also be the first sign of brain anomalies recognizable only in the third trimester or even after delivery, such as cortical malformations. The mean percentage of anomalies not recognized at the time of the first diagnosis of mild VM is 12.8% [3,11,13,15,18,20,27]. A more recent review of nine studies reporting data on postnatal imaging, showed a prevalence of previously undiagnosed findings of 7.4% [21].…”

“…Measurements between 10 and 15 mm constitute mild VM, also defined as borderline ( Figure 1); values above 15 mm constitute severe VM. Some authors [27] use the term "milder VM" and "moderate VM" to indicate measurements of 10-12 and 12.1-15 mm, respectively. Other authors [4] restrict the term "mild VM" to measurements between 10 and 12 mm.…”