Clinical Study And Intrauterine Outcome Of Fetal Lateral Ventricular Dilatation

Objective:In prenatal ultrasound screening 88% of fetuses with central nervous system malformations were examined for lateral ventricular dilation.Fetal lateral ventricular dilatation refers to fetal lateral ventricular dilatation at or above 10 mm during pregnancy.According to the degree of fetal lateral ventricular dilatation,fetal lateral ventricular dilatation can be divided into two types: mild lateral ventricular dilatation and severe lateral ventricular dilatation.In clinical practice,part of the lateral ventricle dilated and dissipated by itself,while some fetuses had intrauterine infection,chromosome abnormality and structural abnormality while the lateral ventricle dilatation was detected.Severe lateral ventricular dilatation combined with subarachnoid dilatation,known as "hydrocephalus".Fetal lateral ventricular dilatation is an important reference for the diagnosis of fetal brain structural abnormalities.By means of prenatal ultrasound screening,the development of fetal brain structure can be preliminarily judged,and it is helpful to detect fetal brain malformation as soon as possible.The prognosis of severe lateral ventricular dilatation is poor,if mild lateral ventricular dilatation complicated with intrauterine infection,spina bifida and other symptoms,the prognosis is generally poor.The focus of clinical studies on fetal lateral ventricular dilatation is solitary mild lateral ventricular dilatation,and 4% of isolated mild lateral ventricular dilatation with chromosome abnormalities(normal variation or early symptoms of other diseases).The prognosis of this kind of fetal lateral ventricular dilatation is better,the width of the lateral ventricle is less than 12 mm,and the pathological course and results of intrauterine spontaneous dissipation are better than those of unilateral ventricular dilatation.Ultrasound screening is a safe,low-cost,real-time imaging,no teratogenicity and other advantages,is an important means of prenatal examination,MRI can be used in clinical ultrasound screening as a necessary supplement.At present,there is no unified view on the diagnostic criteria of lateral ventricular dilatation and the evaluation criteria of fetal postnatal development level in both theoretical and practical fields.It is urgent to carry out standardized and high-quality prospective studies.So as to provide scientific guidance and useful reference for clinical practice.In this paper,the clinical manifestation and intrauterine outcome of fetal lateral ventricular dilatation were studied to provide clinical advice for eugenics and genetic counseling.Methods:In this study,105 pregnant women(single fetus)who went to Qingdao Women and Children Hospital for fetal nervous system malformation from January 2016 to December2016 were selected for antenatal consultation and verified by ultrasound examination in our hospital as "fetal lateral ventricle dilatation".According to the degree of dilatation of lateral ventricle and other structural abnormalities,105 cases were divided into mild lateral ventricular dilatation group(group A),moderate lateral ventricular dilatation group(group B)and severe lateral ventricular dilatation group(group C).According to whether other abnormalities were combined,the three groups were further divided into isolated lateral ventricular dilatation group(isolated lateral ventriculomegaly,IVM)and non-isolated lateral ventricular dilatation group(non-isolated lateral ventriculomegaly,N-IVM).Thirty pregnant women with normal fetal development were screened for genetic diseases,chromosome nucleoplasmic malformations and other structural variants,which were included in the healthy control group.After signing the written informed consent form,all the people included in the study adopted a retrospective cohort study method,using ultrasound screening and nuclear magnetic resonance imaging as the main means of examination,combined with questionnaires and interviews.Different research methods,such as laboratory data analysis.According to the results of antenatal examination,pregnancy outcome and fetal development from birth to 2 years old in the case group and the control group,the data obtained during the follow-up were compared and analyzed with the help of SPSS19.0software,and the corresponding conclusions were drawn.Results:In this study,there were 105 cases in the experimental group,including 12 cases of uterine progress(11.4%),11 cases of narrowing(10.5%),34 cases of stability(32.4%)and48 cases of normal recovery(45.7%).The constrictor and the person who returns to normal are considered to be receded by the addition of the constrictor and the person who returns to normal,In the mild lateral ventricle dilatation group,the regression rate was 84.4% and the progress rate was 8.9%,in the moderate lateral ventricular dilatation group,the regression rate was 59.9% and the progress rate was 14.7%.In the IVM group,The regression rate was82.6% and the progress rate was 2.2%.In the N-IVM group,the regression rate was 35.6%and the progress rate was 18.6%.The progress rate in moderate N-IVM group was significantly higher than that in other groups.(P < 0.05).In this study,25 of 57 neonates diagnosed as lateral ventricle dilatation were followed up dynamically at 6 months,1 year,1.5 years and 2 years after birth.The results showed that nervous system symptoms occurred significantly in the non-isolated group.Conclusion:(1)There was significant difference in intrauterine progress between mild and moderate lateral ventricular dilatation groups.(2)The adverse prognosis of the non-isolated lateral ventricular expansion group was significantly higher than that of the isolated lateral ventricular expansion group.(3)In severe lateral ventricular dilatation group,most of them were complicated with abnormal prognosis and poor prognosis.