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[Meta analysis of fetal lateral ventriculomegaly and prognosis]
1Department of Perinatal Medicine, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing 100026, China.
Insights
Fetal ventriculomegaly prognosis varies by severity and isolation. Mild or isolated cases show better neurological outcomes at one year, while severe or non-isolated cases have poorer prognoses and potential links to chromosomal abnormalities.
Area of Science:
- Neurology
- Fetal Medicine
- Developmental Pediatrics
Background:
- Ventriculomegaly, an abnormal enlargement of the cerebral ventricles, is a common finding in fetal ultrasound.
- Understanding the long-term neurological development of fetuses with ventriculomegaly is crucial for accurate prognosis and management.
Purpose of the Study:
- To systematically review and meta-analyze the neurological prognosis of fetuses diagnosed with ventriculomegaly at one year of age.
- To identify factors influencing neurological outcomes, including severity and isolation of ventriculomegaly.
Main Methods:
- A comprehensive literature search was conducted across multiple databases (Wanfang, CNKI, CBM, PubMed, EMBASE, Cochrane Library) from 1980 to 2017.
- High-quality studies (Newcastle-Ottawa Scale > 5) were selected and analyzed using meta-analysis with R software.
- Heterogeneity testing guided the selection of appropriate statistical models for prognosis analysis.
Main Results:
- Good neurological prognosis rates were 88% for mild, 57% for moderate, and 36% for severe ventriculomegaly.
- Isolated ventriculomegaly showed a good prognosis rate of 86%, compared to 58% for non-isolated cases.
- The incidence of chromosomal abnormalities was 7%, and the improvement rate of lateral ventricle width during pregnancy was 41%.
Conclusions:
- Neurological prognosis is significantly better in mild and isolated fetal ventriculomegaly compared to moderate/severe or non-isolated cases.
- Fetal ventriculomegaly may be associated with chromosomal abnormalities and intrauterine infections.
- Regular monitoring of fetal lateral ventricular width and early pediatrician consultation are recommended for at-risk pregnancies.
Abstract:
Objective: To explore the neurological development of fetal with ventriculomegaly at 1 year after birth by systematically reviewing the domestic and international literature about prognosis of fetal ventriculomegaly. Methods: Wanfang database, CNKI, CBM, PubMed, EMBASE and the Cochrane Library were online searched to collect relevant literature published from January 1st, 1980 to November 22th, 2017. Literature were extracted based on the Newcastle-Ottawa Scale (NOS) , and analyzed by R software for meta-analysis. The corresponding model was selected according to the results of heterogeneity test to comprehensively analyze the prognosis of the fetus with ventriculomegaly. Results: Five studies were included in the meta analysis, all of them were of high quality (scores>5) . (1) The good prognosis rate of nervous system was 88% (95%CI:0.77-0.95) in fetus with mild ventriculomegaly, was 57% (95%CI:0.18-0.91) in those with moderate ventriculomegaly, and was 36% (95%CI:0.16-0.59) in those with severe ventriculomegaly. (2) The good prognosis rate of the nervous system was 86% (95%CI:0.75-0.94) in fetus with the isolated ventriculomegaly, while was 58% (95%CI:0.20-0.91) in those with non-isolated ventriculomegaly. The incidence of chromosomal abnormalities was 7% (95%CI:0.05-0.09) in ventriculomegaly. The improvement rate of lateral ventricle width in pregnancy was 41% (95%CI:0.27-0.57) . Conclusions: The prognosis of nervous system with mild ventriculomegaly is better than that of moderate and severe ventriculomegaly. The prognosis of nervous system with isolated ventriculomegaly is better than that of non-isolated ventriculomegaly. Fetal ventriculomegaly may be associated with fetal chromosomal abnormalities and intrauterine infection. The variation of fetal lateral ventricular width should be monitored regularly during pregnancy, the risk of poor prognosis should be informed, and pediatrician should be asked for evaluation.
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