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Current prognosis in fetal ventriculomegaly
G L Rosseau1, D C McCullough, A L Joseph
1Department of Neurosurgery, Children's Hospital, Washington, D.C.
Journal of Neurosurgery
|October 1, 1992
Summary
Fetal ventriculomegaly diagnosis in utero leads to shunt placement for hydrocephalus in most survivors. However, untreated infants show better cognitive outcomes, suggesting caution with interventions.
Area of Science:
- Neuroscience
- Pediatric Neurology
- Fetal Medicine
Background:
- Fetal ventriculomegaly is a common finding during prenatal ultrasound.
- Management of isolated fetal ventriculomegaly remains a clinical challenge.
- Understanding long-term outcomes is crucial for informed counseling.
Purpose of the Study:
- To evaluate the outcomes of infants diagnosed with fetal ventriculomegaly.
- To assess the impact of shunt placement on cognitive development.
- To identify potential subgroups that may benefit from in utero interventions.
Main Methods:
- Retrospective review of 51 cases with fetal ventriculomegaly.
- Analysis of follow-up data for 40 patients.
- Comparison of cognitive outcomes between shunt-treated and non-treated infants.
Main Results:
- Of 37 delivered infants, 26 (70%) required shunt placement for hydrocephalus.
- Survival rate was approximately 50% with a 4-year average follow-up.
- Untreated infants had significantly better cognitive outcomes (86%) compared to shunt-treated infants (38%).
- No subgroup benefiting from in utero treatment was identified.
Conclusions:
- Fetal ventriculomegaly diagnosis has significant implications for neonatal outcomes.
- Current management strategies, including shunt placement, have variable success rates.
- Further research is needed to optimize treatment and counseling for fetal ventriculomegaly.