Neurological Outcome in Fetuses with Mild and Moderate Ventriculomegaly - Revista Brasileira de Ginecologia e Obstetrícia

Abstract

Introduction

Ventriculomegaly (VM) is one the most frequent anomalies detected on prenatal ultrasound. Magnetic resonance imaging (MRI) may enhance diagnostic accuracy and prediction of developmental outcome in newborns.

Purpose

The aim of this study was to assess the correlation between ultrasound and MRI in fetuses with isolated mild and moderate VM. The secondary aim was to report the neurodevelopmental outcome at 4 years of age.

Methods

Fetuses with a prenatal ultrasound (brain scan) diagnosis of VM were identified over a 4-year period. Ventriculomegaly was defined as an atrial width of 10- 15 mm that was further divided as mild (10.1-12.0 mm) and moderate (12.1-15.0 mm). Fetuses with VM underwent antenatal as well as postnatal follow-ups by brain scan and MRI. Neurodevelopmental outcome was performed using the Griffiths Mental Development Scales and conducted, where indicated, until 4 years into the postnatal period.

Results

Sixty-two fetuses were identified. Ventriculomegaly was bilateral in 58% of cases. A stable dilatation was seen in 45% of cases, progression was seen in 13%, and regression of VM was seen in 4.5% respectively. Fetal MRI was performed in 54 fetuses and was concordant with brain scan findings in 85% of cases. Abnormal neurodevelopmental outcomes were seen in 9.6% of cases.

Conclusion

Fetuses in whom a progression of VM is seen are at a higher risk of developing an abnormal neurodevelopmental outcome. Although brain scan and MRI are substantially in agreement in defining the grade of ventricular dilatation, a low correlation was seen in the evaluation of VM associated with central nervous system (CNS) or non-CNS abnormalities.