Fetal Ventriculomegaly

Abstract

Abstract:The causes of fetal ventriculomegaly vary. Ventriculomegaly can be caused by not only obstruction of cerebrospinal flow tract but also brain maldevelopment or other reasons. Recent advanced imaging technology and approaching technique of transvaginal sonography have contributed to an accurate prenatal diagnosis and clearly revealed fetal intracranial condition. However, management of the condition and counseling of parents are still difficult, because the initial cause, absolute risk, and degree of resulting neurological deficit cannot be determined with confidence. Ventriculomegaly is evaluated according to atrial width > 10 mm and mild ventriculomegaly is defined as an atrial width of 10 to 15 mm. In ventriculomegaly cases, accurate detection of intracranial structure and additional abnormalities is required. Furthermore, ventriculomegaly may resolve spontaneously or progress during pregnancy. Therefore, detailed neuroscan by advanced imaging technology, detailed extra-CNS scan, longitudinal serial scan during pregnancy are mandatory for proper counseling and management. Longitudinal observation study of not only short-term but also long-term neurological prognosis will be required.Key words: Fetus, central nervous system, ventriculomegaly, prenatal diagnosis. Learning objectives• To know imaging technology for fetal CNS assessment.• To know variety of causes of fetal ventriculomegaly.

The Assessment of Fetal Neurobehavior with Four-dimensional Ultrasound: The Kurjak Antenatal Neurodevelopmental Test

“…A second group of parameters is adopted from ATNAT. 42,43 The criterion of quality and quantity of spontaneous GMs is believed to have excellent reliability in evaluating the integrity of fetal CNS. 22,44 Furthermore, a continuity of behavioral patterns from prenatal to the postnatal period has been proven.…”

Three-dimensional Ultrasound in Detection of Fetal Anomalies

“…19,20 From 2000, fetal brain assessment in the second and third trimesters by 3D ultrasound was reported. 17,18,[21][22][23][24][25][26][27][28][29][30] Recent advanced 3D ultrasound has enabled to assess detailed brain structure as an understandable organ. Three-dimensional ultrasound abilities, such as tomographic ultrasound imaging and three orthogonal view, greatly contribute to evaluation of fetal brain morphology.…”

Fetal Behavior assessed by Four-dimensional Sonography

“…As mentioned above, parameters used by KANET are a mixture of general movements, signs adopted by the ATNAT, and these are based on the fact that there is a continuity from fetal life to neonatal life after delivery, plus the fact that the integrity of the fetal nervous system is up to a point represented by the quality and quantity of the movements that a fetus has in utero and its overall behavior. 22,[44][45][46][47][48][49]…”