Chiu Tsung-Hong, Haliza Ghazali, Lin Ying-Hsuan, Hung Tai-Ho, Hsu Jenn-Jeih, Hsieh T'sang-T'ang, Lo Liang-Ming
Department of Obstetrics and Gynecology, Chang Gung Memorial Hospital, Taipei, Taiwan.
Department of Obstetrics and Gynecology, Chang Gung Memorial Hospital, Taipei, Taiwan.
Taiwan J Obstet Gynecol. 2014 Jun;53(2):170-7. doi: 10.1016/j.tjog.2014.04.008.
To evaluate the outcomes associated with fetal ventriculomegaly.
Reports of women who underwent ultrasound scanning between 18 and 36 weeks of gestation during the period from January 1, 2000, to December 31, 2010, were reviewed. According to the defined severity of ventriculomegaly of affected fetuses, the women were divided into the following groups: (1) mild ventriculomegaly (Group A); (2) moderate ventriculomegaly (Group B); and (3) severe ventriculomegaly (Group C). The women were classified into the "gray zone" group if the fetal lateral ventricle measured between 7 mm and <10 mm. All cases were followed up with additional ultrasound scans. Postnatal information was obtained from the computer database or the medical charts.
A total of 41 cases were recruited for this analysis. Four (9.8%) cases had an abnormal karyotype. Twelve women (29.3%) opted for termination of pregnancy. Of the 29 women who delivered, 56.1% (N = 23) were from Group A, 14.6% (N = 6) were from Group B, and none was from Group C. All children in Group A had normal neurological development. Three children in Group B had normal neurological development, whereas the other three had neurologic deficits. A total of 432 cases were classified into the "gray zone" group. Of these cases, 2.8% (N = 12) progressed to ventriculomegaly.
Cases of isolated and mild ventriculomegaly without additional structural anomalies or chromosomal aberrations had good prognoses. However, the parents of fetuses with moderate or severe ventriculomegaly should be counseled regarding related risks. If the ventricular size of the fetus falls within the "gray zone", at least one additional exam in the third trimester should be performed, for early detection of ventriculomegaly and other related abnormalities. It is important to make the parents of these fetuses aware of these risks, from a medico-legal point of view.
评估与胎儿脑室扩大相关的结局。
回顾了2000年1月1日至2010年12月31日期间在妊娠18至36周接受超声扫描的女性的报告。根据受影响胎儿脑室扩大的定义严重程度，将这些女性分为以下几组：（1）轻度脑室扩大（A组）；（2）中度脑室扩大（B组）；（3）重度脑室扩大（C组）。如果胎儿侧脑室测量值在7毫米至<10毫米之间，则将这些女性分类为“灰色地带”组。所有病例均通过额外的超声扫描进行随访。产后信息从计算机数据库或病历中获取。
本分析共纳入41例病例。4例（9.8%）核型异常。12名女性（29.3%）选择终止妊娠。在29名分娩的女性中，56.1%（N = 23）来自A组，14.6%（N = 6）来自B组，C组无。A组所有儿童神经发育正常。B组3名儿童神经发育正常，另外3名有神经功能缺损。共有432例被分类为“灰色地带”组。其中，2.8%（N = 12）进展为脑室扩大。
孤立性轻度脑室扩大且无其他结构异常或染色体畸变的病例预后良好。然而，对于中度或重度脑室扩大胎儿的父母，应就相关风险提供咨询。如果胎儿脑室大小处于“灰色地带”，应在孕晚期至少进行一次额外检查，以便早期发现脑室扩大及其他相关异常。从医疗法律角度让这些胎儿的父母了解这些风险很重要。
