Ventriculomegaly is the most frequent fetal brain anomaly. Hydrocephalus occurs when csf builds up within the ventricles of the brain, causing. To evaluate the prenatal and postnatal follow up, treatment. We analyzed retrospectively 3 medical files concerning fetus that were diagnosed as having one or two ventricles of 10 mm and a follow up for prenatal diagnosis. Mild fetal cerebral ventriculomegaly or borderline ventriculomegaly is defined as an axial diameter 10 mm across the atrium of the posterior or anterior horn of lateral ventricles at any gestation. Any information contained in this pdf file is automatically generated from digital material submitted to epos by third parties in the form of scientific presentations. Eight fetuses were delivered and had congenital malformations. Mild cerebral ventriculomegaly on prenatal ultrasound next.
Data on pregnancy outcome were available in all cases. Karyotypes were available for 6 of these 8 malformed fetuses and chromosomal aberrations were found in 3 trisomy 18, 45xo, triploidy. Important in itself, it is also associated with other cns anomalies. It can be detected at the secondtrimester ultrasound, and occurs in about one in 1,000 births. Ventricles measuring between 10 to15 mm are called mild ventriculomegaly. Isolated mild ventriculomegaly can be a normal variant associated with normal offspring outcome, but ventriculomegaly can also be caused by a variety of disorders that result in neurologic, motor, andor cognitive impairment.
Mild ventriculomegaly means that one or both of the babys lateral ventricles are slightly larger than usual. The mean diameter of the lateral ventricle has been reported to range from 5. Management of the condition and counselling of parents are difficult, as the cause, absolute risk, and degree of resulting handicap cannot be determined with confidence. Sometimes ventriculomegaly is associated with developmental problems of the fetal spine called neural tube defects or spina bifida. It also depends on the timing of the diagnosis as most patients will opt for a termination of pregnancy if the diagnosis is made before 24 weeks gestation. Distribution of ventriculomegaly cases according to severity and the presence or absence of asymmetry. Pdf evaluation of fetal ventriculomegaly researchgate. Fvm is diagnosed when either or both lateral ventricular dilatation equals or exceeds 10 mm at the. Fetal ventriculomegaly is a congenital finding that affects the brain.
Fetal ventriculomegaly ventricle width 10 mm is an important finding in itself and it is also associated with other central nervous system abnormalities. Cesarean section if the fetal head circumference is 40 cm. Ultrasound scans every 4 weeks to monitor the evolution of ventriculomegaly. In 267 consecutive cases of fetal lateral cerebral ventriculomegaly, additional fetal malformations were detected by. The objective of our study was to evaluate the agreement between ultrasonography and mr imaging in the. We studied 25 consecutive fetuses with bmv and evaluated patients characteristic, ultrasonographic findings, and the neurodevelopmental outcome at age. The objective of our study was to evaluate the agreement between ultrasonography and mr imaging in the measurement of the.
Studies often retrospective of postnatal outcomes indicate that the. Mild cerebral ventriculomegaly on prenatal ultrasound next steps and clinical implications learning objectives and cmedisclosure information this activity is intended for healthcare providers delivering care to women and their families. Cerebral ventriculomegaly is one of the most commonly detected fetal anomalies at the midtrimester ultrasound. The contents of the brain consist primarily of brain tissue, blood and cerebrospinal fluid csf.
When this measurement is between 10 and 15 mm, the ventriculomegaly may be described as mild to moderate. Fetal ventriculomegaly differential radiology reference. The prognosis for fetal vm has varied from poor to very good, for both. A look at what ventriculomegaly means during pregnancy. Dysmorphic ventriculomegaly is a form of complex ventriculomegaly best exemplified by agenesis of the corpus callosum with its characteristic ventricular morphology, that is, retention of the teardropshaped fetal configuration posteriorly colpocephaly and a steerhorn configuration anteriorly see chapter 2. Jan 11, 20 this study aimed to evaluate postnatal outcome of fetuses affected by nonprogressive, isolated, mild. Accurate measurement of the lateral ventricles is of paramount importance in prenatal diagnosis. In a case, the ventriculomegaly evolved rapidly to a hydrocephalus. For more information, see the main article fetal ventriculomegaly. Be able to counsel patients about the risks and benefits of open maternalfetal surgery for fetuses with myelomeningocele outline the evaluation process to determine who is a candidate for open maternalfetal surgery. For measuring the lateral ventricle it is recommended to use an axial view of the brain and to place the clipers at the level of the parietooccipital fissure that is usually well demonstrated from 20 weeks. Mild ventriculomegaly, defined as a lateral ventricular diameter of. The qualitative documents about isolated and combined ventriculomegaly groups. This activity is intended for healthcare providers delivering care to women and their families.
Fetal cerebral ventriculomegaly is a relatively common finding on second trimester obstetric ultrasound examination. Fetal ventriculomegaly is the widening of the fluidfilled spaces of the brain. Fetal ventriculomegaly radiology reference article. Severe carries a significant risk 17% the finding of any ventriculomegaly is sufficient to warrant the offer of karyotyping to all women of any age. Accepted article anatomical subgroup analysis of the meridian cohort. Mild fetal cerebral ventriculomegaly fetal diagn ther 2005.
Fetal ventriculomegaly 373 was performed in only 30 cases. Ventriculomegaly is frequently associated with a large number of intra and extracranial chromosomal as well as nonchromosomal anomalies. Anatomical subgroup analysis of the meridian cohort. It is usually diagnosed at a routine fetal anomaly scan at 1822. Mild ventriculomegaly in the fetus, natural history, associated findings and outcome of isolated mild ventriculomegaly. Ventriculomegaly vm, a nonspecific dilatation of the lateral cerebral ventricles, is the most common central nervous system cns abnormality identified with prenatal imaging techniques 1. Pregnant women were referred for mri after an ultrasound examination demonstrated fetal vm, defined as ventricular size measured at the atrium of the lateral ventricle. Enlargement of the ventricular system, the fluidfilled spaces in the brain, can be caused by the overproduction of csf, inadequate brain development or destruction of brain tissue. Mild cerebral ventriculomegaly on prenatal ultrasound.
Ventriculomegaly vm is defined as an enlargement of the lateral ventricles of the developing fetal brain. Ventriculomegaly is an excess of fluid in the lateral ventricles within the developing cerebrum. There is not a singular cause of ventriculomegaly, but it is common in conjunction with hydrocephalus and several fetal abnormalities. It can be a variation of the normal or the sign of an underlying pathology.
The vp shunt procedure will be performed by a pediatric neurosurgeon. Ventriculomegaly ultrasonography of the prenatal brain. Inclusion criteria included referral for vm or an ultrasound examination at one of our institutions demonstrating vm, and agreement to participate in the study. Fetal ventriculomegaly fvm is a frequently detected anomaly in the second and third trimester ultrasound scanning. Possible conflicting classifications caused by their measurement in different sectional planes by sonography and mr imaging are frequently raised. Introduction ventriculomegaly is the most frequent fetal brain anomaly. Counseling of patients is difficult because the cause and accurate prognosis cannot be determined with confidence 2 8.
Ventriculomegaly is a brain condition that mainly occurs in the fetus when the lateral ventricles become dilated. All cases were diagnosed between 22 and 27 weeks of gestation by an ultrasound. Ventriculomegaly ultrasonography of the prenatal brain, 3e. The outcome of fetal ventriculomegaly depends on the presence of associated abnormalities which carry a poor prognosis. Fetal ventriculomegaly due to isolated brain malformations. A vp shunt is the surgical implantation of a small plastic catheter that drains the cerebrospinal fluid into a part of the body that can easily absorb the fluid such as the abdomen or peritoneum membrane that forms the lining of the abdominal cavity. Fetal ventriculomegaly fvm is defined as an enlargement of the lateral cerebral ventricles of the fetus. It is usually diagnosed at a routine fetal anomaly scan at 1822 weeks gestation. Fetal ventriculomegaly fvm is a commonly detected anomaly in the second and third trimester ultrasound scanning. Ventriculomegaly is a condition in which the lateral ventricles of the brain the fluidfilled spaces appear larger than normal. Isolated ventriculomegaly and risk of chromosome anomaly borderline probably caries a risk of % but data is still limited. The most common definition uses a width of the atrium of the lateral ventricle of greater than 10 mm.
The generic term ventriculomegaly has been preferred to ventricular dilatation andor hydrocephalus, which already presupposes a pathophysiological mechanism 1. Isolated mild fetal ventriculomegaly m wyldes, m watkinson arch dis child fetal neonatal ed 2004. A personalized dti analysis technique with applications to the screening of preterm infants. Ventriculomegaly is a term that describes the actual image of the enlarged spaces as it appears on a prenatal ultrasound. As a result, the large ventricles can inhibit the proper development of the brain. Method and materials 29 fetuses mean gestationa weel k. Megan is a bright, thoughtful, and creative little person who loves to be independent and continually amazes my husband and me. Ouahba j, luton d, vuillard e, garel c, gressens p, blanc n, elmaleh m, evrard p, oury j. A standard examination of the fetus includes prenatal sonographic evaluation of the cerebral ventricles, which can be detected as early as 15 weeks gestational age, and their measurement is part of the assessment of the central nervous system cns. She also recently scored in the 99th percentile in an academic screening offered through our school district.
This study aimed to evaluate postnatal outcome of fetuses affected by nonprogressive, isolated, mild. A literature search was performed to identify all reports of antenatal vm in the english language literature. Outcome of prenatallydetected fetal ventriculomegaly. Outcome of prenatallydetected fetal ventriculomegaly springerlink. Postnatal outcome of isolated, nonprogressive, mild. Moderate carries a significant risk of a chromosome anomaly 14%. When enlargement of the lateral ventricles 10 mmis identified, a thorough evaluation should be.
Mild ventriculomegaly is different from the more severe form of ventriculomegaly, hydrocephalus or water on the brain. Current evidence suggests that magnetic resonance imaging mri is indicated when the isolated ventriculomegaly ivm on ultrasound is severe 15. Exclusion of fetal ventriculomegaly with a single measurement. Fetal brain anomalies associated with ventriculomegaly or.
Pregnancy outcomes and followups in ten years bioscience trends, vol. If the inline pdf is not rendering correctly, you can download the pdf file here. Measurement of the size of the fetal cerebral lateral ventricles is. The normal fetal lateral ventricular diameter remains stable at 10 mm over gestation. Are there any medical complications associated with ventriculomegaly. Fetal vm can be isolated or associated to other anomalies including structural abnormal findings, chromosomal anomalies and prenatal infections in up to 50% of cases 4,5,6. Fetal cerebral ventriculomegaly is defined as an atrial diameter of. Neurodevelopmental outcome of fetuses referred for. Hydrocephalus is the main concern associated with ventriculomegaly. Using the current sonographic cutoff criteria see radiographic features below, the estimated prevalence may be at 0. Ventriculomegaly, also known as hydrocephalus, is a condition in which the csffilled structures within the brain become larger than normal. Ventriculomegaly is defined as dilation of the fetal cerebral ventricles and is a relatively common finding on prenatal ultrasound. F9f ventriculomegaly is an excess of fluid in the lateral ventricles within the developing cerebrum. Copy number variations with isolated fetal ventriculomegaly.
132 558 1291 1118 1620 1078 268 1411 158 947 1483 1364 1002 1251 211 1277 237 828 863 393 1481 1612 1331 590 1121 89 253 76 49 178 66 368 973 130 1135 1617 1650 760 1512 1442 212 932 89 323 1055 848 1349 353