Laskin Matthew D, Kingdom John, Toi Ants, Chitayat David, Ohlsson Arne
Department of Obstetrics & Gynecology, Mount Sinai Hospital, University of Toronto, Canada.
J Matern Fetal Neonatal Med. 2005 Nov;18(5):289-98. doi: 10.1080/14767050500329775.
To establish the perinatal and neurodevelopmental outcomes of fetuses diagnosed with isolated ventriculomegaly (IVM).
A systematic review of cohort, case/control studies, case series and case reports of IVM (unilateral or bilateral enlargement of the lateral ventricle, >or=10 mm, with no additional diagnosis at the time of the initial ultrasound), identified by searching, without language restrictions, The Cochrane Library, MEDLINE and Embase databases in June 2004.
No cohort study was retrieved but 577 cases were identified in one case/control study and 29 case series/case reports. Of 207 cases with follow-up and known gestational age at diagnosis, normal developmental outcomes were found in 82%, mild impairments in 9% and moderate/severe impairments in 10%. Prenatal diagnosis could possibly have reduced the risk of moderate/severe impairments to 7%. In 137 cases followed to at least 20 months of age, 79% had normal neurodevelopment, 10% were mildly delayed and 11% had moderate/severe developmental delays.
Outcome was favorable in 85% of IVM cases, decreasing to 79% when cases were followed to at least 20 months of age. We recommend prospective cohort studies with new diagnostic modalities to better identify the underlying conditions relating to moderate/severe impairments in the remaining cases.
确定诊断为孤立性脑室扩大（IVM）胎儿的围产期及神经发育结局。
通过检索2004年6月的Cochrane图书馆、MEDLINE和Embase数据库，对IVM（侧脑室单侧或双侧扩大，≥10 mm，初次超声检查时无其他诊断）的队列研究、病例/对照研究、病例系列及病例报告进行系统评价，检索无语言限制。
未检索到队列研究，但在1项病例/对照研究中确定了577例，在29项病例系列/病例报告中确定了577例。在207例有随访且诊断时已知孕周的病例中，82%发育结局正常，9%有轻度损害，10%有中度/重度损害。产前诊断可能将中度/重度损害的风险降至7%。在137例随访至至少20月龄的病例中，79%神经发育正常，10%轻度延迟，11%有中度/重度发育延迟。
85%的IVM病例结局良好，随访至至少20月龄时降至79%。我们建议采用新的诊断方法进行前瞻性队列研究，以更好地确定其余病例中与中度/重度损害相关的潜在情况。
