THE OUTCOME OF FETAL VENTRICULOMEGALY

Over a 5 year period 38 cases of fetal ventriculomegaly were diagnosed at Queen's Medical Centre, Nottingham. There were 12 cases of spina b ifida and all patients opted for a termination of pregnancy. There wer e 15 cases of isolated ventriculomegaly comprising seven cases of aque duct stenosis, four abnormalities of the corpus callosum, one cavum se ptum pellucidum cyst, one case of porencephaly and two cases of mild l ateral ventricular dilatation. The fetuses in this group had a relativ ely good outcome with five babies showing normal development, three wi th mild developmental delay and one with moderate developmental delay. There was one stillbirth and five patients opted for a termination of pregnancy. Associated abnormalities were seen in seven cases and thes e carried a poor prognosis with one fetus stillborn, one neonatal deat h, and three patients opted for a termination of pregnancy. Two babies were liveborn, one has severe developmental delay and the other one i s normal. The four remaining cases included two Dandy Walker syndrome, one brain tumour and one case of subdural haemorrhage. There were thr ee terminations of pregnancy and one stillbirth in this group. The out come of fetal ventriculomegaly depends on the presence of associated a bnormalities which carry a poor prognosis. It also depends on the timi ng of the diagnosis as most patients will opt for a termination of pre gnancy if the diagnosis is made before 24 weeks gestation. A review of the literature reveals that, excluding terminations, fetuses with iso lated ventriculomegaly have an 80% chance of survival and a 50% chance of normal development.