den Hollander N S, Vinkesteijn A, Schmitz-van Splunder P, Catsman-Berrevoets C E, Wladimiroff J W
Department of Obstetrics and Gynaecology, Academic Hospital Rotterdam Dijkzigt, Sophia Children's Hospital, Rotterdam, The Netherlands.
Prenat Diagn. 1998 Jun;18(6):557-66. doi: 10.1002/(sici)1097-0223(199806)18:6<557::aid-pd303>3.3.co;2-v.
The purpose of the present study was to determine the postnatal outcome and prognostic factors of prenatally diagnosed ventriculomegaly, and to establish the relationship between prenatal sonographic measurements and postnatal psychomotor development. A total of 42 singleton pregnancies with sonographically determined fetal ventriculomegaly at 20-38 weeks' gestation were reviewed, together with follow-up data on postnatal outcome at a mean of 29 months after delivery. Sonographic measurements included head circumference, cerebral lateral ventricular diameter at the anterior and posterior horn level, and hemisphere diameter. Classification of psycho-motor development consisted of assessment of motoric behaviour, speech, communication and social skills ('Van Wiechen' classification). Perinatal mortality rate was 38 per cent, of which half were directly associated with cephalocentesis. Only the ventricle/hemisphere ratio for the anterior and posterior horn of the lateral cerebral ventricles was significantly higher among perinatal deaths than amongst the survivors. Within the subset of survivors (n = 26), psycho-motor development was normal in 46 per cent. Postnatal examination revealed syndrome anomalies in five infants, of which four were associated with psycho-motor retardation. Prenatally diagnosed ventriculomegaly has a poor postnatal outcome with more than 50 per cent of the live-born infants demonstrating abnormal psycho-motor development. The predictive value of fetal biometric measurements is poor. The presence of syndromal anomalies emphasizes the need for genetic counselling in future pregnancies.
本研究的目的是确定产前诊断为脑室扩大的产后结局及预后因素，并建立产前超声测量与产后心理运动发育之间的关系。回顾了总共42例单胎妊娠，这些妊娠在妊娠20 - 38周时经超声检查确定为胎儿脑室扩大，并收集了产后平均29个月的随访结局数据。超声测量包括头围、大脑侧脑室前角和后角水平的直径以及半球直径。心理运动发育分类包括对运动行为、言语、沟通和社交技能的评估（“范维兴”分类）。围产期死亡率为38%，其中一半与头颅穿刺直接相关。仅大脑侧脑室前角和后角的脑室/半球比在围产期死亡者中显著高于幸存者。在幸存者亚组（n = 26）中，46%的心理运动发育正常。产后检查发现5例婴儿有综合征异常，其中4例与心理运动发育迟缓有关。产前诊断为脑室扩大的产后结局较差，超过50%的活产婴儿表现出异常的心理运动发育。胎儿生物测量的预测价值较差。综合征异常的存在强调了未来妊娠进行遗传咨询的必要性。
