Hidaka Nobuhiro, Ishii Keisuke, Kanazawa Ryoko, Miyagi Akiko, Irie Akemi, Hayashi Shusaku, Mitsuda Nobuaki
Department of Maternal Fetal Medicine, Osaka Medical Center and Research Institute for Maternal and Child Health, Izumi, Japan.
J Obstet Gynaecol Res. 2014 Apr;40(4):1030-6. doi: 10.1111/jog.12298. Epub 2014 Feb 26.
Fetal borderline ventriculomegaly represents a frequent dilemma in perinatal management. The present study aimed to evaluate the clinical significance of fetal borderline ventriculomegaly in a low-risk Japanese population and to identify the risk factors for associated anomalies.
Data of cases of fetal borderline ventriculomegaly detected at 26-28 weeks of gestation by routine ultrasonographic screening of low-risk singleton pregnancies between 2006 and 2012 were retrospectively collected. Ventricular width, in utero progression, associated anomalies, chromosomal abnormalities, and perinatal and postnatal outcomes were assessed. The ventricular width, in utero progression and other perinatal characteristics were compared between the isolated and non-isolated groups.
Among the total 6020 singleton low-risk pregnancies, we noted that 42 had borderline ventriculomegaly. Six (14%) of these cases had other defects by subsequent detailed examination. Ventriculomegaly resolved or regressed in 35 (83%) and progressed in four (10%) cases, of which three were associated with other anomalies. The median ventricular width was 12.8 mm (range, 10.0-14.7) in the six non-isolated cases and 10.5 mm (range, 10.0-13.3) in the 36 isolated cases; the differences were statistically significant. A ventricular width of 12 mm or more and in utero progression were more frequently observed in non-isolated cases than in isolated cases.
Fetal borderline ventriculomegaly frequently resolves in utero. A ventricular diameter of more than 12 mm and in utero progression are risk factors for additional anomalies. After the initial diagnosis of borderline ventriculomegaly, the pregnancy should be carefully followed up to determine whether the ventricle size is resolved, remains stable or increases.
胎儿临界性脑室扩大是围产期管理中常见的难题。本研究旨在评估日本低风险人群中胎儿临界性脑室扩大的临床意义，并确定相关异常的危险因素。
回顾性收集2006年至2012年期间通过常规超声筛查低风险单胎妊娠在孕26 - 28周时检测出的胎儿临界性脑室扩大病例的数据。评估脑室宽度、宫内进展情况、相关异常、染色体异常以及围产期和产后结局。比较孤立性和非孤立性病例组的脑室宽度、宫内进展情况及其他围产期特征。
在总共6020例低风险单胎妊娠中，我们发现42例有临界性脑室扩大。其中6例（14%）经后续详细检查发现有其他缺陷。35例（83%）脑室扩大情况缓解或消退，4例（10%）进展，其中3例与其他异常相关。6例非孤立性病例的脑室宽度中位数为12.8毫米（范围10.0 - 14.7），36例孤立性病例为10.5毫米（范围10.0 - 13.3）；差异有统计学意义。非孤立性病例比孤立性病例更常观察到脑室宽度≥12毫米及宫内进展情况。
胎儿临界性脑室扩大常在宫内缓解。脑室直径大于12毫米及宫内进展是出现其他异常的危险因素。在初步诊断为临界性脑室扩大后，应密切随访妊娠情况，以确定脑室大小是缓解、保持稳定还是增大。
