THE OUTCOME OF INFANTS DIAGNOSED PRENATALLY AS HAVING CEREBRAL VENTRICULOMEGALY

Objective: Nonprogressive ventriculomegaly is thought to have a good o utlook, but if additional anomalies are present, the prospects are poo r. This study was undertaken to confirm whether this was so, and to id entify factors that might indicate a good or bad prognosis. Twenty-nin e cases of ventriculomegaly were referred to St. Mary's Hospital in Ma nchester between January 1991 and October 1993. Twenty pregnancies res ulted in live births; the remainder were terminated. Methods: The fami lies of the 20 children were contacted by letter; one was untraceable. The remaining 19 were visited at home or in the hospital. A history w as taken, the child was examined, and development was assessed using I llingworth's Basic Screening tests. Results: Fourteen of the 19 childr en had isolated fetal ventriculomegaly, 8 of which were stable, 2 nonp rogressive, and 4 progressive; 5 had ventriculomegaly associated with anomalies in other viscera. Of the 14 with isolated ventriculomegaly, 11 achieved their developmental milestones and were neurologically int act. Three had delayed milestones and were neurologically abnormal; on e of these had trisomy-21 and the others had family histories suggesti ng a genetic basis for their ventriculomegaly. Two of those with assoc iated anomalies did well. Of 3 remaining, 2 had positive family histor ies suggesting a genetic basis for the abnormalities including the ven triculomegaly, and 1 had been infected in utero with cytomegalic virus . Conclusions: This study indicates that fetuses with stable, resolvin g, or mildly progressive ventriculomegaly have an excellent prognosis provided there is no evidence of chromosomal abnormality, family histo ry of genetic anomalies, evidence of intrauterine infection by a TORCH organism, associated anomalies in the central nervous system or other organs, or a ventricular atrial measurement greater than 2 cm.