| Objective: To investigate the intrauterine outcome of fetuses with isolated mild and moderate lateral ventricle widening(ventriculomegaly,VM)and the high-risk factors affecting the prognosis of the fetus,in order to provide a basis for clinical genetic counseling.Methods: To retrospectively analyze the intrauterine outcome and pregnancy outcome of 208 fetuses diagnosed as isolated mild-to-moderate VM fetuses prenatally.Groups were grouped according to the width of the fetal lateral ventricle during the second trimester: 10≤A group≤12mm,12<B group <15.0mm.Regular follow-up of these pregnant women,record gestational age,first diagnosis gestational age,prenatal ultrasound,MRI and prenatal diagnosis results,collect the pregnancy outcome of the two groups,fetal gender,weight and head circumference and other clinical data.The Denver Intelligence Screening Form was used to assess the growth and development of infants and young children.The comparison of rates between groups used Pearsonc2 test and multivariate Logistic regression analysis to analyze the influencing factors of fetal prognosis.Results: 1.The incidence of isolated mild and moderate VM was 7.0‰,isolated mild VM was 5.8‰,and isolated moderate VM was 1.2‰;isolated mild-moderate VM was different on unilateral and bilateral(P <0.05),but there was no statistical difference in the distribution of gestational age and age at first diagnosis(P>0.05).2.83.8% of ultrasound diagnosis was in accordance with MRI,8 cases were supplemented by MRI,3 cases were diagnosed as ACC by MRI,1 case was diagnosed as posterior cranial Blake cyst by MRI,and 4 cases were diagnosed as accompanied by other related abnormalities by MRI.3.The detection rate of isolated mild and moderate VM chromosomal abnormalities was 19.5%(16/82),and the detection rate of pathogenic chromosomal abnormalities was 14.6%(12/82).The detection rates of chromosome abnormalities in karyotype and SNP arrays analysis were 12.5%(7/56)and 15.3%(4/26),respectively.The additional detection rate of SNP arrays analysis was 17.1%(6/35).4.57.2%(119/208)of the fetal lateral ventricles returned to normal,32.7%(68/208)remained stable,and 10.1%(21/208)found progressive intrauterine widening.The intrauterine outcome of group A was better than that of group B(P<0.05),113 cases of group A resolved spontaneously(63.1%,113/179),and 6 cases of group B resolved spontaneously(20.7%,6/29).The intrauterine outcome of unilateral widening was better than bilateral widening(P<0.05),with unilateral spontaneous resolution in 94cases(65.7%,94/143),and bilateral spontaneous resolution in 25 cases(38.5%,25/65).The intrauterine outcome of bilateral symmetrical VM is better than bilateral asymmetrical VM(P<0.05),23 cases of bilateral symmetrical spontaneous resolution(46.0%,23/50),and 2 cases of bilateral asymmetrical spontaneous resolution(13.3%,2/15).5.20 cases(10.8%,20/185)with abnormal growth and development of infants,including 13 cases in group A(7.7%,13/168),7 cases in group B(41.2%,7/17),two groups of infants The developmental abnormalities were statistically significant(P<0.05).The results of univariate logistic regression analysis showed that the degree of lateral ventricle widening,the maximum change of lateral ventricle width,whether itis progressing in the uterus,and the bilateral asymmetric distribution are related to the prognosis of isolated mild to moderate VM fetuses(P<0.05).Multivariate logistic analysis showed that the maximum lateral ventricle width> 12mm(OR=15.900,P=0.003)and progressive widening(OR=4.458,P=0.041)were independent risk factors for isolated mild-to-moderate VM fetus.Conclusion: 1.The total incidence of isolated mild and moderate VM was 7.0‰,and the incidence of isolated moderate VM was lower than that of isolated mild VM.2.The detection rate of pathogenic chromosomal abnormalities in fetuses with isolated mild to moderate lateral ventricle widening was 14.6%,and the additional detection rate of SNP arrays analysis was 17.1%.3.The intrauterine outcome of a fetus with isolated mild to moderate VM is affected by the width of the lateral ventricle,unilateral and bilateral distribution(whether the bilateral distribution is symmetrical).When the lateral ventricle is found to be continuously widened or the maximum value exceeds 12 mm,Infants and young children are at a higher risk of poor prognosis.It is recommended that pregnant women with high-risk factors need regular ultrasound follow-up and improve MRI and chromosome testing. |
PDF Full Text Request