| Objective : To evaluate the pregnancy outcome and neurological development of fetal lateral ventricular dilatation in different degrees,types and intrauterine outcomes.Methods:A retrospective study was conducted to analyze the clinical data of 175 pregnant women who were admitted to the prenatal diagnosis center of Department of Obstetrics and Gynecology First Affiliated Hospital of Hainan Medical University from March 2016 to June 2020 because of the "lateral ventricle dilatation of fetus" prompted by prenatal ultrasound.Furthermore,karyotyping,100k(100K Pathogen Genome Project),Magnetic Resonance Imagine etc.were used for the confirmation of the diagnosis.Repeated ultrasound was used to monitor the regression,stability and progression of the ventriculomegaly.Clinical data were collected.Gravidas who had chosen to continue their pregnancy were followed up to monitor the variations of fetal ventriculomegaly.The population was divided into three groups according to ventricular width: A(mild ventriculomegaly,10 to 12 mm);B(moderate,12.1 to 14.9 mm)and C(severe,> 15 mm).Chromosome abnormalities were included in all subjects.Neonatal behavioral neurological assessment(NBNA)was used to evaluate the neurological development of 7-day-old newborns.The mental development index(MDI)and psychomotor development index(psychomotor development index)of Bailey Infant and Child Development Scale were used.The neurological development of 6-month-old infants was assessed by ex,PDI.Statistical methods were t test,χ 2 test(or Fisher’s exact probability method),nonparametric test,Mann-Whitney test and Kruskal-Wallis H test.Results:Among the 175 cases,111 cases were confirmed and 65 cases were available for follow up.Ventriculomegaly was more often an isolated finding in Group A(40/65;61%)than in Group B(14/65;22%)and Group C(11/65;17%).When the ventriculomegaly was an isolated finding,95% of fetuses with mild,78.6% with moderate and 9% of those with severe dilatation were alive at 24 months.The neurodevelopmental outcome was normal in93% of Group A,71% of Group B and 9% of Group C.Findings:(1)-the rate of neurological developmental malformations in groups A(mild),B(moderate)and C(severe)are 4(10.8),2(22)and 10(90.9)respectively.-There was significant difference in the genetic results analyzed in group C(χ 2=89.857,P=0.001).There was no significant difference in the genetic results analyzed in groups A and B(χ 2=1.398,P=0.237 and χ2=1.398,P=0.237)(2)The rate of genetic defects of A(mild),B(moderate)and C(severe)are 6(15),3(21)and 3(27)respectively.There was significant difference in the genetic results analyzed in group C(χ 2=40.347,P=0.001).There was no significant difference in the genetic results analyzed in groups A and B(χ 2=8.708,P=0.069 and χ2=3.950,P=0.139)(3)The abortion rate of A(mild),B(moderate)and C(severe)are 3(7.5),2(14)and 10(90.9)respective.There was significant difference in pregnancy outcome in group C(χ 2=100.820,P =0.001).There was no significant difference in groups A and B(χ 2=6.341,P=0.175 and χ2=1.596,P=0.456)Conclusions:1.Our results suggest that that there are more genetic defects in the moderate and severe groups of ventriculomegaly than the mild group which is the borderline ventriculomegaly(width below 12 mm).2.Secondly,we found more cases of abortion in the severe group than that of the moderate and the mild respectively,which means that they are more often associated with the severe form of malformations(poor prognosis).3.Thirdly the neurodevelopmental problems were found in all the three groups,mild,moderate and severe in an increasing order.4.Fetuses with mild lateral ventricular dilatations also have the risk of nervous system dysplasia.6.Attention should be paid to regular follow-up after birth. |
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