430 Prenatal findings and associated survival rates in fetal ventriculomegaly: a prospective observational study

Abstract

The aim was to present the antenatal experience of fetal ventriculomegaly in a large European center in relation to; 1.Grade of ventriculomegaly; 2.Additional chromosomal/structural abnormalities and 3.Perinatal survival rates. This was a prospective observational study of patients referred with fetal ventriculomegaly to the National Maternity Hospital, Dublin, from January 2010 through July 2020 (with Institutional Review Board Approval). Data was obtained from the hospital database and categorized as mild (10-12mm), moderate (13-15 mm) or severe ventriculomegaly (>15mm), as per SMFM recommendations. Data was analyzed and statistical analysis performed using the Chi-Square test. 213 were included for analysis. The mean maternal age was 31.6 years, the mean gestation at diagnosis was 25+6 weeks (17 to 38+5 weeks) and the mean gestation at delivery was 38+3 weeks (33 -41+7 weeks). There was bilateral and unilateral ventriculomegaly in 186/213 (87.3%) and 27/213 (12.7%) cases respectively. Ventriculomegaly was mild in 92/213 (43.2%), moderate in 25/213 (11.7%) and severe in 96/213 (45.1%). 114/213 (53.5%) had additional structural abnormalities on ultrasound (US), of which 43/213 (20.2%) had intracranial findings only. 27/213 (12.7%) had underlying chromosomal abnormalities (21 diagnosed antenatally, 6 postnatally). No difference was observed in the rate of chromosomal abnormalities between the groups, though those with mild ventriculomegaly and additional US features had higher rates of chromosomal abnormalities than those with isolated ventriculomegaly (IVM), 12/49 (24.5%) vs 4/43 (9.3%), P<0.05 (Table 1). 28/213 (13.1%) had termination of pregnancy and 18/213 (8.5%) had a subsequent neonatal death. The overall survival was 167/213 (78.4%) . No difference was observed in the survival rates between the groups, though those with additional US findings in the mild and the severe groups had worse survival rates of 61.2% and 67.31% (P<0.05)(Table 1). In this cohort, fetuses with IVM had survival rates greater than 90% and chromosomal abnormalities under 10% in all groups.