Analysis Of Clinical And Radiographic Follow-up Results Of Fetuses With Mild To Moderate Isolated Ventriculomegaly

Objective:To evaluate the postpartum follow-up clinical outcome and radiographic result of infants diagnosed of mild-to-moderate isolated ventriculomegaly.Methods:This was a cohort study of 134 gravidas with singleton pregnancy whose fetus was diagnosed as mild-to-moderate isolated ventriculomegaly(IVM)by ultrasound in Nan-fang Hospital affiliated to Southern Medical University from Jan 2014 to Dec 2018.Fetal lateral ventricle width?10mm and<12mm were mild ventriculomegaly(mild group),and?12mm and<15mm were moderate ventriculomegaly(moderate group).Gravidas who had chosen to continue their pregnancy were followed up to monitor the variations of fetal ventricular,and clinical data such as gestational age,diagnostic gestational week,prenatal ultrasound and prenatal diagnosis results,pregnancy outcome,fetal birth gender,weight and head circumference were recorded.Neonatal Behavioral Neurological Assessment(NBNA)and Bayley Scales of Infant Development(BSID)was used in 7 days and 12 months after birth for nervous system development situation assessment,combining with the ultrasound and magnetic resonance imaging results.Results:(1)Antcnatal diagnosis:Among 134 IVM fetus indicated by ultrasound.chromosome karyotype analysis indicated chromosome abnormality rate of 5.9%(10/1 34).The additional detection rate of CMA was 13.7%(10/73).(2)The results of prenatal imaging examination showed that 79.9%?16.4%and 3.7%of the prenatal IVM fetus subsided,stabilized and progressed,respectively.Prenatal MRI examination was completed in 64 cases,and 8 cases who were IVM indicated by ultrasound,while MRI examination indicated fetal ventriculomegaly with intracranial microstructural abnormalities,mainly brain dysplasia and corpus callosum dysplasia.The detection rate of additional MRI abnormalities was 12.5%(8/64).(3)Results of postpartum imaging examination:In 66 cases(54.1%,66/122),11 cases(1.7%,11/66)indicated ventriculomegaly,and among which 4 cases with other structural abnormalities,namely 3 cases with abnormal white matter and 1 cases with corpus callosum dysplasia.(4)Results of postpartum clinical follow-up:79(64,8%,79/122)children with IVM received NBNA score at 3 to 7 days after birth and BSID score at 12-30 months.The scores of NBNA and BSID of children with mild and moderate IVM after birth were compared,and the differences were not statistically significant(P>0.05).The BSID scale score of 8 newborns(10.1%,8/79)was low in intellectual or physical development,three of whom MRI indicated abnormal white matter development.Conclusion:Although there is a large amount of data on IVM,the differences in the prognosis of mild-to-moderate IVM fetuses suggest that further study is necessary.Most of our research of mild-to-moderate IVM children have good results.However,no matter for children with mild or moderate IVM,even intrauterine outcome is good,there is still a risk of nervous system dysplasia.Therefore must be close postpartum follow-up,including the assessment of MRI and clinical scale,in order to early find and rehabilitation.