Clinical Outcomes of Fetal Ventriculomegaly: A Retrospective Analysis from a Tertiary Referral Center

To evaluate perinatal outcomes in fetal ventriculomegaly (VM).

We retrospectively reviewed 720 pregnancies diagnosed with fetal ventriculomegaly (VM) between 2014 and 2018. Cases were classified as isolated ventriculomegaly (IVM, n = 451) or non-isolated ventriculomegaly (NIVM, n = 269) based on the presence of additional prenatal imaging abnormalities. According to the width of the lateral ventricles, VM was further categorized as mild (10-11.9 mm, n = 555), moderate (12-14.9 mm, n = 88), or severe (≥15 mm, n = 77). Serial prenatal ultrasound measurements were used to evaluate intrauterine progression, which was defined as regressive (≥2 mm decrease), stable (<2 mm change), or progressive (≥2 mm increase) ventricular width. Periodic antenatal and postnatal imaging data were collected, and pregnancy outcomes were obtained through medical records and telephone follow-up.

Overall, favorable outcomes were observed in 93.75% of IVM cases, with rates of 95.31% in mild, 89.2% in moderate, and 25.0% in severe VM. In IVM cases, severe VM (OR = 60.214), intrauterine stability (OR = 5.687), and progression (OR = 34.88), were significantly associated with adverse outcomes. The NIVM group showed a significantly higher rate of pregnancy termination compared with the IVM group (39.5% vs 8.9%, p < 0.05). Among ongoing pregnancies, adverse outcomes were also more frequent in the NIVM group than in the IVM group (15.6% vs 6.25%, p < 0.05). Among cases with adverse outcomes, persistent intracranial imaging abnormalities were identified in 66.7% of NIVM cases and 57.1% of IVM cases.

NIVM correlates with high termination/adverse outcome rates. VM severity intrauterine stability and progression are key risk factors, necessitating continuous imaging surveillance for optimal management.