CLINICAL OUTCOME OF MILD FETAL VENTRICULOMEGALY

OBJECTIVE: Our purpose was to evaluate the outcome of fetuses with mil d cerebral ventriculomegaly. STUDY DESIGN: We prospectively collected all cases of mild cerebral ventriculomegaly (transverse diameter of th e atrium of the cerebral lateral ventricles between 10 and 15 mm) diag nosed antenatally between January 1990 and December 1996. Associated u ltrasonographic abnormalities including markers of aneuploidy, presenc e of chromosomal anomalies, structural malformations detected al birth , and neurologic outcome were recorded. Outcome information was availa ble on all cases. in addition, published series of cases of fetal mild cerebral ventriculomegaly were reviewed to identify prognostic indica tors. RESULTS: Eighty-two cases fulfilled the inclusion criteria: 48 w ere isolated and 34 were associated with other ultrasonographic marker s or anomalies. Among the 45 surviving euploid isolated cases, neurolo gic follow-up was normal at a mean age of 28 months (range 3 to 72 mon ths). Male fetuses and those with a transverse atrial size <12 mm had a good prognosis. Ventricular atria greater than or equal to 12 mm wer e more often associated with other anomalies (56% vs 6%) and, when iso lated, with abnormal postnatal neurodevelopment (23% vs 3%). Aneuploid y was present in two cases of isolated mild cerebral ventriculomegaly, both of which were associated with advanced maternal age, and in seve n cases associated with other anomalies. CONCLUSIONS: Mild cerebral ve ntriculomegaly should prompt targeted ultrasonographic examination, in clusive of markers of aneuploidies, visualization of the corpus callos um, and echocardiogram as we[las serologic evaluation for congenital i nfections, In isolated mild cerebral ventriculomegaly genetic counseli ng should take into account clinical, laboratory, and ultrasonographic findings. A review of the published series suggests that cognitive or motor delay is predominantly mild and that it occurs in about 9% of c ases of isolated mild cerebral ventriculomegaly.