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Antenatally detected ventriculomegaly in south wales: incidence and outcome for a seven-year cohort
  1. C Sidebotham1,
  2. J te Water Naude1,
  3. RB Beattie2,
  4. S Maguire3
  1. 1Department Child Health, Cardiff and Vale University Health Board, Cardiff, UK
  2. 2Department Fetal Medicine, Cardiff and Vale University Health Board, Cardiff, UK
  3. 3Department Child Health, Cardiff University, Cardiff, UK

Abstract

Aim While antenatal ventriculomegaly is common, it varies in severity and outcome, with sparse UK data. The authors aim to define the incidence, associated abnormalities and infant outcome for a UK cohort.

Methods All cases of antenatally detected ventriculomegaly attending a single regional fetal medicine unit from May 2001 to October 2008 were entered prospectively onto a database. Ventriculomegaly was defined as mild (10–12 mm), moderate (12–15 mm) or severe (>15 mm) by ultrasonography (coronal slice at the level of the atria). Progressive ventriculomegaly was defined as an increase in the diameter >2 mm, regressed as a reduction >2 mm and stable as a change of <2 mm. Coexistent anomalies, investigations and pregnancy outcome were analysed, and where available infant records at age 6/12 were obtained.

Results A total of 210 cases were identified, giving an incidence of 1.5 cases per 1000 live births in South Wales. Among these, 36% were isolated and 64% non-isolated. Ventricular dilatation was mild in 95/197 (48%), moderate in 38 (19%) and severe in 64 (33%). Seventy per cent of mild cases were isolated. Severity was significantly associated with associated anomalies (p<0.0001). Twenty-seven per cent of mild cases underwent termination of pregnancy. Of 108 cases with consecutive data, mild cases were more likely to regress or remain stable than moderate/severe cases (p<0.0001). There were 89 live births, of whom 48% were mild, 24% moderate and 15% severe. Postnatal details were available on 48 children, 15 (31%) of whom were normal. Among the 34 with postnatal abnormalities, 11 had mild ventriculomegaly, 3 moderate and 20 severe.

Conclusion With an incidence of 1.5/1000 live births in this UK cohort, ventriculomegaly is a common antenatal abnormality. Clearly, regressive cases are more likely to be mild, isolated and have a normal outcome than progressive cases. The positive outcome for mild cases in this series raises the question as to the appropriateness of a 10-mm cutoff. A prospective study with detailed paediatric follow-up is required to define optimal cutoff values and allow appropriate counselling.

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