Serlo W, Kirkinen P, Jouppila P, Herva R
Childs Nerv Syst. 1986;2(2):93-7. doi: 10.1007/BF00286228.
An antenatal diagnosis of fetal hydrocephalus was made in 38 cases. Using certain criteria for the assessment of fetal prognosis, 23 cases were considered to be severely affected. Postnatal evaluation of these 23 cases established the extensive severity of fetal abnormality in all cases. The prognosis was estimated to be more favorable in 10 cases, of which 8 were delivered by elective cesarean section and 2 by spontaneous vaginal delivery. In 9 cases a ventriculoatrial shunting procedure was performed early in the neonatal period, while 1 case was treated conservatively. Follow-up of these 10 cases (at 7 months to 5 years of age) revealed normal or subnormal development in 6 cases and severe retardation in 4. Fetal hydrocephalus proved to have several etiological causes and was associated with other anomalies in 84% of cases. Severe forms of fetal hydrocephalus can, by means of modern ultrasound techniques, be detected before the 20th gestational week. Some cases of fetal hydrocephalus progress slowly during the fetal period. These can be followed until term by repeated ultrasound examinations and good or moderate prognosis can be expected with the use of early postnatal therapy. Only a minority of hydrocephalic fetuses seem to be potential objects for antenatal shunting.
共对38例胎儿脑积水进行了产前诊断。依据某些评估胎儿预后的标准，其中23例被判定为严重受累。对这23例病例的产后评估证实，所有病例中胎儿异常的严重程度都很高。预计10例预后较好，其中8例通过择期剖宫产分娩，2例经自然阴道分娩。9例在新生儿期早期进行了脑室心房分流术，1例采取保守治疗。对这10例病例（7个月至5岁）的随访显示，6例发育正常或发育迟缓，4例严重发育迟缓。事实证明，胎儿脑积水有多种病因，84%的病例伴有其他畸形。借助现代超声技术，严重类型的胎儿脑积水可在孕20周前被检测出来。部分胎儿脑积水病例在胎儿期进展缓慢。通过反复超声检查对这些病例进行监测直至足月，采用早期产后治疗有望获得良好或中等预后。只有少数脑积水胎儿似乎适合进行产前分流。
