Perinatal and neurodevelopmental outcome with isolated fetal ventriculomegaly: A systematic review

Article Outline

• Objective
• Study design
• Results
• Conclusion
• Copyright

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Objective 

To establish the perinatal and neurodevelopmental outcomes of fetuses diagnosed with isolated ventriculomegaly (IVM).

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Study design 

A systematic review of the literature using cohort and case/control studies, case series and case reports. Studies of IVM (unilateral or bilateral enlargement of the lateral ventricle [>10 mm] with no additional diagnosis at the time of the initial ultrasound) were identified by searching The Cochrane Library, MEDLINE and Embase databases in June 2004 without language restrictions.

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Results 

No cohort study, one case/control study and 29 case series/case reports were identified yielding 518 cases. Long-term outcomes were reported at different postnatal ages using different tests to assess motor and cognitive outcomes. Of 206 cases with follow-up and with known gestational age at diagnosis, normal developmental outcomes were found in 82%, mild impairments in 8.7% and moderate/severe impairments were present in 9.7%. Additional conditions amenable to prenatal diagnosis were present in 10 cases of which four had moderate/severe impairment and one was a stillborn fetus with trisomy 21. Prenatal diagnosis of these conditions could have reduced the risk of moderate/severe impairments to 6.7%.

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Conclusion 

This systematic review includes the largest number of cases of IVM to date. Although based on low level of evidence the current best estimates are that the outcome is favorable in 82% of the cases of IVM. Prospective cohort studies incorporating new diagnostic modalities (fetal MRI) should be undertaken to better identify the underlying conditions related to the presence of moderate/severe impairments in the remaining 7-10% of cases.