Prenatal ultrasound predictors of postnatal major cerebral abnormalities in fetuses with apparently isolated mild ventriculomegaly

Prenat Diagn. 2015 Aug;35(8):783-8. doi: 10.1002/pd.4607. Epub 2015 May 24.

Abstract

Objective: We aim to examine the incidence of major cerebral abnormalities on postnatal imaging in cases with isolated mild ventriculomegaly on fetal sonography and to evaluate the relationship between the presence or absence of such defects and prenatal ultrasound factors.

Methods: We searched our databases to identify all cases with mild ventriculomegaly (10-15 mm) and no other major structural abnormalities on prenatal ultrasound, with normal karyotype and no evidence of maternal or fetal infection. For each case, we retrieved data on prenatal ultrasound follow-up, fetal magnetic resonance imaging (MRI), neonatal ultrasound and/or brain MRI, and pregnancy outcome.

Results: Postnatal imaging revealed a major cerebral abnormality in 9 (6.9%) of 130 live borns with isolated mild ventriculomegaly on prenatal ultrasound. In six (66.7%) of nine cases, the abnormality was known or suspected prenatally on fetal MRI. Multivariate analysis showed that the only significant contribution to the prediction of major cerebral abnormalities was provided by persistence or progression of ventricular enlargement on serial ultrasound examinations (p = 0.001, odds ratio 21.1 [95% confidence interval: 3.6-122.7]).

Conclusion: Prenatal ultrasound follow-up identifies fetuses at higher risk for a major cerebral abnormality among cases with isolated mild ventriculomegaly. In cases with persistent or progressive enlargement, fetal MRI and postnatal imaging seem appropriate.

Publication types

  • Evaluation Study

MeSH terms

  • Adult
  • Brain / abnormalities*
  • Female
  • Follow-Up Studies
  • Humans
  • Hydrocephalus / diagnostic imaging*
  • Hydrocephalus / etiology
  • Incidence
  • Infant, Newborn
  • Magnetic Resonance Imaging
  • Male
  • Nervous System Malformations / complications
  • Nervous System Malformations / diagnosis*
  • Nervous System Malformations / epidemiology
  • Pregnancy
  • Retrospective Studies
  • Severity of Illness Index
  • Ultrasonography, Prenatal*