| Background and objective:Ventriculomegaly is one of the most frequent fetal brain anomaly.More soft index abnormalities are found with the widespread use of ultrasonography,but there is no clear basis for its intrauterine outcome and clinical prognosis.Previous studies have reported that prognosis may be related to the changes in lateral ventricles width and if there is associated abnormality.By discussing the prenatal assessment and clinical prognosis of fetuses affected by different degrees of ventriculomegaly,to provide basis for prenatal counceling and management of pregnancy.Matrials and Methods:A retrospective study was conducted among the 142 singleton pregnant women with ventriculomegaly subjected to the futher MRI assessment in the China-Japan Union Hospital of Jilin University between January 2016 and December 2017.The population was divided into three groups according to ventricular width:Mild Group(10~12mm),Moderate Group(12~15mm)and Severe Group(>15mm).The subjects were examined according to whether they had associate abnormalities(isolated and associated).According to the changes in the width of the lateral ventricle,the cases were divided in to three groups:Regress Group,Stable Group and Progress Group.To determine possible etiologies,results of TORCH infections and Down Syndrome were also routinely recorded.The results of neurodevelopmental outcome of babies were followed up by telephone using the Gesell developmental scale.Chi-square test(or Fisher's exact test)was used for statistics.Results:142 cases were enrolled,27 cases were lost to follow-up,twelve were still remain prenatal,one hundred and three fetuses were followed up to postnatal(twelve cases terminated were included).There are 25 fetuses whose diagnoses of MRI were inconsistent with the results of ultrasonography,of which 10 cases were corrected by MRI and 15 cases were supplemented.Among the 103 postnatal cases,56 cases in Mild Group,35 cases in Moderate Group and 12 cases in Severe Group.When the outcomes of the three groups were compared,6 of 56 cases in the Mild Group(10.7%),7 of 35 cases in the Moderate Group(20.0%),and 7 of 12 cases in the Severe Group(58.3%)had significant abnormalities.Statistically significant differences were found between the three groups(?~2=14.333,P=0.001).Statistical significance was observed in the Moderate Group and Severe Group(?~2=4.579,P=0.032),while the Mild Group had a more favorable prognosis than the Severe Group(?~2=11.576,P=0.001),and there is no statistically significant difference between the Mild group and Moderate group(?~2=1.517,P=0.218).During ultrasound follow up of the 103 cases,66 cases in regressed Group,30 cases in stable Group and 7 cases in progressed Group.When the outcomes of the three groups were compared,6 of 66cases in the Regress Group(9.1%),8 of 30 cases in the Stable Group(26.7%),and 6 of 7 cases in the Progress Group(85.7%)had significant abnormalities.Statistically significant differences were found between the three groups(?~2=25.169,P=0.000).Statistical significance was observed in the Stable Group and Progress Group(Fisher's test,P=0.007),while the Regress Group had a more favorable prognosis than the Progress Group(?~2=21.760,P=0.000).The prognosis of fetus with non-isolated ventriculomegaly was poorer than that of fetus with isolated ventriculomegaly(?~2=12.522,P=0.000).Chromosomal examinations of Down's screening was carried out in 86 cases,11 cases were in high risk(8 in 21trisomy).Infection screening of TORCH was performed in 65 cases and 5 cases were found to be positive,one case was operated after progressing to hydrocephalus half a year after birth.Conclusion:It is of great value in accurate diagnosis of lateral ventriculomegaly and additional malformation by using combination of MRI and ultrasonography.The prognosis of the non-isolated is usually poor,and the Progress Group and Severe Group should be intervened early for their poorer prognosis. |
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