Prognostic signs in fetal hydrocephalus.

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.