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Prognostic Features and Long-Term Outcome in Patients with Isolated Fetal Ventriculomegaly
Alice Winkler1, Sandra Tölle, Giancarlo Natalucci
1Clinic of Obstetrics, University Hospital Zürich, Zürich, Switzerland.
Insights
Long-term outcomes for fetal isolated ventriculomegaly (IVM) show that while diameter and progression are not strongly linked to most outcomes, cerebral and genetic anomalies significantly impact prognosis.
Area of Science:
- Prenatal diagnosis and counseling
- Pediatric neurology
- Medical imaging
Background:
- Fetal isolated ventriculomegaly (IVM) is a condition diagnosed via ultrasound.
- Accurate long-term outcome prediction is crucial for prenatal counseling.
- Previous studies have limited data on the long-term clinical and imaging outcomes of IVM.
Purpose of the Study:
- To evaluate long-term clinical and imaging outcomes in children with fetal isolated ventriculomegaly (IVM).
- To identify predictors of outcome in IVM for improved prenatal counseling.
- To assess the association between IVM characteristics and neurodevelopmental outcomes.
Main Methods:
- Retrospective analysis of 72 fetuses diagnosed with IVM between 1999 and 2011.
- Review of atrial diameter measurements in the axial plane.
- Association analysis of IVM characteristics with outcome parameters, including receiver operating characteristic (ROC) curve analysis.
Main Results:
- Postnatal diagnosis of cerebral anomalies in 42% and genetic disorders in 12% of live births.
- Significant association found between IVM degree and genetic disorders (AUC=0.866).
- Significant association found between IVM progression and motor impairment (AUC=0.789).
- Favorable outcomes were observed when cerebral or genetic anomalies were absent postnatally.
Conclusions:
- IVM diameter and progression are not significantly associated with most outcome parameters.
- Cerebral anomalies and genetic disorders are key contributors to unfavorable outcomes in IVM.
- Absence of postnatal cerebral or genetic anomalies suggests a favorable prognosis for IVM.
Objective:
In order to provide aid for prenatal counseling in fetal isolated ventriculomegaly (IVM) on ultrasound, we recorded the latest long-term clinical and imaging outcomes of children with a mean age of 7.2 years (range 2.1-14.6).
Methods:
In 72 fetuses with IVM, diagnosed between 1999 and 2011, the measurement quality of atrial diameter was reviewed in the axial plane. We assessed the association of characteristics of IVM with outcome parameters in the cohort and in subgroups. Prognostic values of significant associations were reported by receiver operating characteristic curve analysis.
Results:
Cerebral anomalies were diagnosed postnatally in 42% and genetic disorders in 12% of 45 live births. Significant associations of outcome parameters were found between the degree of IVM and genetic disorders (p = 0.017) with an area under the curve (AUC) of 0.866, and between progression of IVM and motor impairment (p = 0.024) with an AUC of 0.789. No significant correlation was found with the other assessed outcome parameters. Furthermore, our subgroup analysis clearly showed that, if cerebral or genetic anomalies are not found postnatally, a favorable outcome may be expected.
Discussion:
Diameter and progression in IVM are not significantly associated with most outcome parameters. Cerebral anomalies and genetic disorders may contribute to an unfavorable outcome.
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