Gupta J K, Bryce F C, Lilford R J
Department of Obstetrics and Gynaecology, Ninewells Hospital, Dundee, Scotland.
Obstet Gynecol Surv. 1994 Oct;49(10):716-21. doi: 10.1097/00006254-199410000-00027.
Early ultrasound examination can provide accurate antenatal diagnosis of many fetal congenital abnormalities but it is often difficult to translate this into prognosis because of the variable functional effects of similar anatomical changes. In the case of isolated fetal ventriculomegaly it is the prognosis that parents require in order to choose between continuing with the pregnancy or termination. The outcome for antenatally diagnosed ventriculomegaly seems to be worse than that reported in the neurosurgical literature for children treated with congenital hydrocephalus. Follow-up is available for 276 cases with apparently isolated ventriculomegaly who did not undergo termination of pregnancy. One hundred ninety-four (70 per cent) survived and of these 114 (59 per cent) had normal developmental quotient to follow-up. Intrapartum cephalocentesis to aid vaginal delivery is almost invariably associated with fetal/neonatal death. A favorable outcome of normal mental development is present in cases with borderline, stable (nonprogressive) isolated ventriculomegaly or cases in which ventriculomegaly has resolved in utero. Fetal surgery would seem to offer no benefit. The outcome is much worse when other associated congenital anomalies are present.
早期超声检查能够对许多胎儿先天性异常做出准确的产前诊断，但由于相似解剖学改变的功能影响存在差异，往往难以据此推断预后情况。对于孤立性胎儿脑室扩大，父母需要依据预后情况来决定是继续妊娠还是终止妊娠。产前诊断出的脑室扩大患儿的预后似乎比神经外科文献中报道的先天性脑积水患儿的预后更差。对276例未终止妊娠、明显为孤立性脑室扩大的病例进行了随访。其中194例（70%）存活，在这些存活病例中，有114例（59%）在随访时发育商正常。为协助阴道分娩而进行的产时头颅穿刺几乎总会导致胎儿/新生儿死亡。临界性、稳定（非进行性）孤立性脑室扩大病例或脑室扩大在子宫内已消退的病例，智力发育通常良好。胎儿手术似乎并无益处。若存在其他相关先天性异常，预后则要差得多。
