P11.04: Obstetric and neonatal outcomes in fetal cerebral ventriculomegaly

Abstract

To evaluate obstetric and neonatal outcomes of fetuses with cerebral ventriculomegaly (VM). Retrospective review of 302 cases of fetal cerebral VM from 2013-2017. Cases grouped into Isolated mild VM (lateral ventricle 10 to 15 mm), complex mild VM (with additional sonographic features) and severe VM (lateral ventricle diameter >15mm). Ancillary investigations performed (infection serology, karyotype evaluation, magnetic resonance imaging and ultrasonographic follow-up) were reviewed. Obstetric and neonatal outcomes were recorded. Among 302 cases with VM, 257 (85.1%) classified as mild and 45 (14.9%) severe, with mean atrial diameter 10.9mm and 23.3mm respectively. Other ultrasound abnormalities were found in 52(20.2%) complex mild VM cases. CMV and Toxoplasmosis serology was done in (82.9%), amniotic fluid was sent in 31/257(12%) for CMV Toxo PCR and infection was excluded in all cases. Amniocentesis done for karyotype in 71/257 (27.4%) cases of mild VM and 9/45 (20%) of severe VM. Out of 52 apparently isolated mild VM, 4 had chromosomal aberrations while 20% of complex mild and severe VM associated with aneuploidy. 27 cases underwent MRI study, with diagnostic confirmation of associated cerebral malformations in all cases. Spontaneous in utero resolution of VM occurred in 115/257 (44.7%) of mild VM cases while 79/257 (30.7%) remained stable and about 12 (4.7%) progressed to severe VM. 21/302 opted for pregnancy termination. 174 (85%) of isolated mild, 25 (48%) of complex mild and 25 (55.6%) of severe VM fetuses were liveborn. Among severe VM, 44% were progressive, 15% remained stable. Male female ratio was noted to be 1.8:1. Complex and severe VM cases required early and operative delivery more often compared to isolated mild VM. Prenatal workup including MRI and aneuploidy testing provided useful information. Infection serology was notably negative in all cases. Majority of fetuses with isolated mild VM had good perinatal outcome, however cases with progressive or complex mild or severe VM had poorer prognosis. Please note: The publisher is not responsible for the content or functionality of any supporting information supplied by the authors. Any queries (other than missing content) should be directed to the corresponding author for the article.