The Ultrasonographic Findings of Ventriculomegaly in 2nd And 3rd Trimester with Fetal Outcomes: Ultrasonographic Findings of Ventriculomegaly

Saba  Feroz; Noraiz Ali; Zain Ul Hasan; Zareen  Fatima; Nadia Hina; Arsal Jahangir; Manahil Gill; Ayesha Arshad; Areeba Rouf

doi:10.54393/pjhs.v4i02.465

Authors

Saba Feroz University Institute of Radiological Sciences and Medical Imaging Technology, The University of Lahore, Lahore, Pakistan
Noraiz Ali University Institute of Radiological Sciences and Medical Imaging Technology, The University of Lahore, Lahore, Pakistan
Zain Ul Hasan University Institute of Radiological Sciences and Medical Imaging Technology, The University of Lahore, Lahore, Pakistan
Zareen Fatima University Institute of Radiological Sciences and Medical Imaging Technology, The University of Lahore, Lahore, Pakistan
Nadia Hina University Institute of Radiological Sciences and Medical Imaging Technology, The University of Lahore, Lahore, Pakistan
Arsal Jahangir University Institute of Radiological Sciences and Medical Imaging Technology, The University of Lahore, Lahore, Pakistan
Manahil Gill University Institute of Radiological Sciences and Medical Imaging Technology, The University of Lahore, Lahore, Pakistan
Ayesha Arshad University Institute of Radiological Sciences and Medical Imaging Technology, The University of Lahore, Lahore, Pakistan
Areeba Rouf University Institute of Radiological Sciences and Medical Imaging Technology, The University of Lahore, Lahore, Pakistan

DOI:

https://doi.org/10.54393/pjhs.v4i02.465

Keywords:

Ventriculomegaly (VM), Spinal defects (SD), Ultrasonography (USG)

Abstract

In the second trimester, fetal ventriculomegaly is a typical finding on obstetrical ultrasonography. It is clinically relevant since it can be caused by a variety of disorders that cause brain, motor, and/or cognitive impairment. Many cases are associated with other abnormalities, but in other cases, ventriculomegaly is the only abnormality. Objective: To evaluate the incidence of ventriculomegaly in 2^nd and 3^rd trimester with fetal outcomes. Methods: A descriptive study was conducted at of University of Lahore Ultrasound Clinic Greentown for duration of 4 months. Total 774 females were presented at hospital for in 2^nd and 3^rd trimester. All participants underwent transabdominal ultrasound using 3-5 MHz curvilinear probe. Written informed consent was obtained from all participants. Results: Total 774 women in 2^nd and 3^rd trimester of their pregnancy were included in our study. Out of 774 patients 700 were with cephalic presentation and 74 were with breech presentation. Variables including Spinal defect types, ventriculomegaly and ventricular involvement were noted. Out of 774 patients, 22 patients had fetal ventriculomegaly, 2 patients were with meningocele, 3 were with myelomeningocele and 16 patients were with spina bifida occluta. Ventricular involvement was as follow: In 5 fetuses, fourth ventricle was involved, in 15 fetuses lateral ventricles were involved and in 2 fetuses third ventricle was involved. Conclusion: Findings from this study concluded that Severity of ventriculomegaly is highly associated with fetal spinal defects.

References

Griffiths PD, Reeves MJ, Morris JE, Mason G, Russell SA, Paley MN, et al. A prospective study of fetuses with isolated ventriculomegaly investigated by antenatal sonography and in utero MR imaging. American Journal of Neuroradiology. 2010 Jan; 31(1): 106-11. doi: 10.3174/ajnr.A1767

Cardoza JD, Goldstein RB, Filly RA. Exclusion of fetal ventriculomegaly with a single measurement: the width of the lateral ventricular atrium. Radiology. 1988 Dec; 169(3): 711-4. doi: 10.1148/radiology.169.3.3055034

Goldstein I, Reece E, Pilu G-L, Hobbins J. Sonographic Evaluation of the Normal Developmental Anatomy of Fetal Cerebral Ventricles. IV.: The Posterior Horn. American Journal of Perinatology. 1990 Jan; 7(01): 79–83. doi: 10.1055/s-2007-999452

Farrell TA, Hertzberg BS, Kliewer MA, Harris L, Paine SS. Fetal lateral ventricles: reassessment of normal values for atrial diameter at US. Radiology. 1994 Nov; 193(2): 409-11. doi: 10.1148/radiology.193.2.7972754

Alagappan R, Browning PD, Laorr A, McGahan JP. Distal lateral ventricular atrium: reevaluation of normal range. Radiology. 1994 Nov; 193(2): 405-8. doi: 10.1148/radiology.193.2.7972753

Achiron R, Schimmel M, Achiron A, Mashiach S. Fetal mild idiopathic lateral ventriculomegaly: is there a correlation with fetal trisomy?. Ultrasound in Obstetrics and Gynecology: The Official Journal of the International Society of Ultrasound in Obstetrics and Gynecology. 1993 Mar; 3(2): 89-92. doi: 10.1046/j.1469-0705.1993.03020089.x

Melchiorre K, Bhide A, Gika AD, Pilu G, Papageorghiou AT. Counseling in isolated mild fetal ventriculomegaly. Ultrasound in Obstetrics and Gynecology: The Official Journal of the International Society of Ultrasound in Obstetrics and Gynecology. 2009 Aug; 34(2): 212-24. doi: 10.1002/uog.7307

Malinger G, Paladini D, Haratz KK, Monteagudo A, Pilu GL, Timor‐Tritsch IE. Practice Guidelines (updated): sonographic examination of the fetal central nervous system. Part 1: performance of screening examination and indications for targeted neurosonography. Ultrasound Obstetric & Gynecology. 2020 Sep; 56(3): 476-84. doi: 10.1002/uog.22145

Filly RA, Goldstein RB, Callen PW. Fetal ventricle: importance in routine obstetric sonography. Radiology. 1991 Oct; 181(1): 1-7. doi: 10.1148/radiology.181.1.1887016

Goldstein RB, La Pidus AS, Filly RA, Cardoza J. Mild lateral cerebral ventricular dilatation in utero: clinical significance and prognosis. Radiology. 1990 Jul; 176(1): 237-42. doi: 10.1148/radiology.176.1.2191365

Bromley B, Frigoletto FD, Benacerraf BR. Mild fetal lateral cerebral ventriculomegaly: clinical course and outcome. American Journal of Obstetric Gynecology. 1991 Mar; 164(3): 863e7. doi: 10.1016/0002-9378(91)90530-5

Patel MD, Filly AL, Hersch DR, Goldstein RB. Isolated mild fetal cerebral ventriculomegaly: clinical course and outcome. Radiology. 1994 Sep; 192(3): 759e64. doi: 10.1148/radiology.192.3.7520183

Almog B, Gamzu R, Achiron R, Fainaru O, Zalel Y. Fetal lateral ventricular width: what should be its upper limit? A prospective cohort study and reanalysis of the current and previous data. Journal of Ultrasound in Medicine. 2003 Jan; 22(1): 39-43. doi: 10.7863/jum.2003.22.1.39

Giardini V, Verderio M, Cozzolino S, Vergani P. Isolated spina bifida aperta: prenatal ventriculomegaly as an ultrasound prognostic marker. Prenatal Diagnosis. 2019 Oct; 39(11): 1035-7. doi:10.1002/pd.5509

Morris JE, Rickard S, Paley MN, Griffiths PD, Rigby A, Whitby EH. The value of in-utero magnetic resonance imaging in ultrasound diagnosed foetal isolated cerebral ventriculomegaly. Clinical Radiology. 2007 Feb; 62(2): 140-4. doi: 10.1016/j.crad.2006.06.016

Copp AJ, Adzick NS, Chitty LS, Fletcher JM, Holmbeck GN, Shaw GM. Spina bifida. Nature Reviews Disease Primers. 2015 Apr; 1(1) :15007. doi: 10.1038/nrdp.2015.7

Mohd-Zin SW, Marwan AI, Abou Chaar MK, Ahmad-Annuar A, Abdul-Aziz NM. Spina bifida: pathogenesis, mechanisms, and genes in mice and humans. Scientifica. 2017 Feb; 2017: 1-30. doi: 10.1155/2017/5364827

Masini L, De Luca C, Noia G, Caruso A, Lanzone A, Rendeli C, et al. Prenatal diagnosis, natural history, postnatal treatment and outcome of 222 cases of spina bifida: experience of a tertiary center. Ultrasound in Obstetrics & Gynecology. 2019 Mar; 53(3): 302-8. doi: 10.1002/uog.20136

Yousaf S, Khadija S, Asad N, Fatima M, GILANI SA, Laique T. Sonographic Association of Ventriculomegaly and Neural Tube Anomalies. Pakistan Journal of Medical and Health Sciences. 2021 May; 15(5): 1021-3. doi: 10.53350/pjmhs211551021

Zhao D, Cai A, Wang B, Lu X, Meng L. Presence of chromosomal abnormalities in fetuses with isolated ventriculomegaly on prenatal ultrasound in China. Molecular Genetics & Genomic Medicine. 2018 Nov; 6(6): 1015-20. doi: 10.1002/mgg3.477