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Vol. 31, No. 1, 2012
Issue release date: February 2012
Section title: Original Paper
Editor's Choice -- Free Access
Fetal Diagn Ther 2012;31:12-18
(DOI:10.1159/000331408)

Mid-Term Neurodevelopmental Outcome in Isolated Mild Ventriculomegaly Diagnosed in Fetal Life

Gómez-Arriaga P.a · Herraiz I.a · Puente J.M.a · Zamora-Crespo B.b · Núñez-Enamorado N.c · Galindo A.a
aFetal Medicine Unit-SAMID, Department of Obstetrics and Gynecology, bPediatric Rare Diseases Unit, Department of Pediatrics, and cPediatric Neurology Unit, Department of Pediatrics, Hospital Universitario ‘12 de Octubre', Madrid, Spain
email Corresponding Author

Abstract

Objective: To analyze mid-term neurodevelopment outcome in children with isolated mild ventriculomegaly (VM) ≤12 mm diagnosed in fetal life, using the Battelle Developmental Inventory Screening Test (BDIST). Methods: 86 cases of mild VM were identified. 68 were excluded due to: other cerebral anomalies (n = 40), extra-cerebral anomalies (n = 3), chromosomal defects (n = 4), dysmorphic syndromes (n = 4), congenital infections (n = 2), termination of pregnancy (n = 9), stillbirth (n = 2) and incomplete follow-up (n = 4). 18 cases (range 1-8 years) of isolated mild VM were included for analysis. Seven neurodevelopment domains were assessed by BDIST. Results: Routine neuropediatrical evaluation detected neurological disorders in five children (28%; 3 with language impairment, one left hemiparesis and one intellectual retardation). BDIST showed some degree of neurodevelopmental delay in higher proportions: 66% in social-personal skills, 56% in gross motor skills, 39% in adaptive behavior and 28% in fine motor skills. Communicative and cognitive areas were the least affected (11 and 22% had moderate-to-severe involvement, respectively). A general trend towards worse outcomes was observed in the group of ≧4 years, although significant differences were only found for gross motor skills. Conclusion: Subtle neurological delays may appear during the infant period in fetuses prenatally diagnosed of isolated mild VM. In consequence, adequate measures should be established for early detection and treatment.

© 2011 S. Karger AG, Basel


  

Key Words

  • Fetal mild ventriculomegaly
  • Neurodevelopmental outcome
  • Prenatal diagnosis
  • Battelle Developmental Inventory Screening Test

References

  1. Pilu G, Hobbins J: Sonography of fetal cerebrospinal anomalies. Prenat Diagn 2002;22:321-330.
  2. Achiron R, Schimmel M, Achiron A, Mashiach S: Fetal mild idiopathic lateral ventriculomegaly: is there a correlation with fetal trisomy? Ultrasound Obstet Gynecol 1993;3:89-92.
  3. Kelly EN, Allen VM, Seaward G, Windrim R, Ryan G: Mild ventriculomegaly in the fetus, natural history, associated findings and outcome of isolated mild ventriculomegaly: a literature review. Prenat Diagn 2001;21:697-700.
  4. Gaglioti P, Danelon D, Bontempo S, Mombrò M, Cardaropoli S, Todros T: Fetal cerebral ventriculomegaly: outcome in 176 cases. Ultrasound Obstet Gynecol 2005;25:372-377.
  5. Graham E, Duhl A, Ural S, Allen M, Blakemore K, Witter F: The degree of antenatal ventriculomegaly is related to pediatric neurological morbidity. J Matern Fetal Med 2001;10:258-263.
  6. Signorelli M, Tiberti A, Valseriati D, Molin E, Cerri V, Groli C, Bianchi UA: Width of the fetal lateral ventricular atrium between 10 and 12 mm: a simple variation of the norm? Ultrasound Obstet Gynecol 2004;23:14-18.
  7. Melchiorre K, Bhide A, Gika AD, Pilu G, Papageorghiou AT: Counseling in isolated mild fetal ventriculomegaly. Ultrasound Obstet Gynecol 2009;34:212-224.
  8. Falip C, Blanc N, Maes E, Zaccaria I, Oury JF, Sebag G, Garel C: Postnatal clinical and imaging follow-up of infants with prenatal isolated mild ventriculomegaly: a series of 101 cases. Pediatr Radiol 2007;37:981-989.
  9. Vergani P, Locatelli A, Strobelt N, Cavallone M, Ceruti P, Paterlini G, Ghidini A: Clinical outcome of mild fetal ventriculomegaly. Am J Obstet Gynecol 1998;178:218-222.
  10. Melchiorre K, Liberati M, Celentano C, Domizio S, Puglielli C, Buoni S, Strambi M, Zannolli R: Neurological outcome following isolated 10-12 mm fetal ventriculomegaly. Arch Dis Child Fetal Neonatal Ed 2009;94:F311-F312.
  11. Gaglioti P, Oberto M, Todros T: The significance of fetal ventriculomegaly: etiology, short- and long-term outcomes. Prenat Diagn 2009;29:381-388.

    External Resources

  12. International Society of Ultrasound in Obstetrics and Gynecology. Sonographic examination of the fetal central nervous system: guidelines for performing the ‘basic examination' and the ‘fetal neurosonogram'. Ultrasound Obstet Gynecol 2007;29:109-116.

    External Resources

  13. Newborg J, Stock JR, Wnek L: Batelle, inventario de desarrollo. Madrid, TEA, 2004.
  14. Berls AT; McEwen IR: Battelle Developmental Inventory. Phys Ther 1999;79:776-783.
  15. Newborg J, Stock JR, Wnek L, Guidubaldi J, Svinicki J: The Battelle Developmental Inventory. Allen, TX: DLM Teaching Resources; 1988.
  16. Salomon LJ, Bernard JP, Ville Y: Reference ranges for fetal ventricular width: a non-normal approach. Ultrasound Obstet Gynecol 2007;30:61-66.
  17. Arora A, Bannister CM, Russell S, Rimmer S: Outcome and clinical course of prenatally diagnosed cerebral ventriculomegaly. Eur J Pediatr Surg 1998;8(suppl 1):63-64.

    External Resources

  18. Pilu G, Falco P, Gabrielli S, Perolo A, Sandri F, Bovicelli L: The clinical significance of fetal isolated cerebral borderline ventriculomegaly: report of 31 cases and review of the literature. Ultrasound Obstet Gynecol 1999;14:320-326.
  19. Rydz D, Srour M, Oskoui M, Marget N, Shiller M, Birnbaum R, Majnemer A, Shevell MI: Screening for developmental delay in the setting of a community pediatric clinic: a prospective assessment of parent-report questionnaires. Pediatrics 2006;118:e1178-e1186.

    External Resources

  20. Glascoe FP, Byrne KE: The usefulness of the Battelle Developmental Inventory Screening Test. Clin Pediatr (Phila) 1993;32:273-280.
  21. Beeghly M, Ware J, Soul J, du Plessis A, Khwaja O, Senapati GM, Robson CD, Robertson RL, Poussaint TY, Barnewolt CE, Feldman HA, Estroff JA, Levine D: Neurodevelopmental outcome of fetuses referred for ventriculomegaly. Ultrasound Obstet Gynecol 2010;35:405-416.
  22. Bloom SL, Bloom DD, DellaNebbia C, Martin LB, Lucas MJ, Twickler DM: The developmental outcome of children with antenatal mild isolated ventriculomegaly. Obstet Gynecol 1997;90:93-97.
  23. Sadan S, Malinger G, Schweiger A, Lev D, Lerman-Sagie T: Neuropsychological outcome of children with asymmetric ventricles or unilateral mild ventriculomegaly identified in utero. Br J Obstet Gynaecol 2007;114:596-602.
  24. Reynolds AJ, Temple JA, Robertson DL, Mann EA: Long-term effects of an early childhood intervention on educational achievement and juvenile arrest: A 15-year follow-up of low-income children in public schools. JAMA 2001;285:2339-2346.
  25. Riethmuller AM, Jones R, Okely AD: Efficacy of interventions to improve motor development in young children: a systematic review. Pediatrics 2009;124:e782-e792.

    External Resources

  26. Ong L, Nolan RP, Irvine J, Kovacs AH: Parental overprotection and heart-focused anxiety in adults with congenital heart disease. Int J Behav Med 2010, DOI: 10.1007/s12529-010-9112-y.

    External Resources

  27. Vermaes IP, Gerris JR, Janssens JM: Parents' social adjustment in families of children with spina bifida: a theory-driven review. J Pediatr Psychol 2007;32:1214-1226.

    External Resources

  28. Chiappedi M, Bejor M: Corpus callosum agenesis and rehabilitative treatment. Ital J Pediatr 2010;36:64.

    External Resources

  29. Joó JG, Tóth Z, Beke A, Papp C, Tóth-Pál E, Csaba A, Szigeti Z, Rab A, Papp Z: Etiology, prenatal diagnostics and outcome of ventriculomegaly in 230 cases. Fetal Diagn Ther 2008;24:254-263.

    External Resources

  

Author Contacts

Dr. A. Galindo
Fetal Medicine Unit
Department of Obstetrics and Gynecology, Hospital Universitario ‘12 de Octubre'
Avenida de Córdoba s/n, ES-28041 Madrid (Spain)
Tel. +34 913 908 310, E-Mail agalindo.hdoc@salud.madrid.org

>

  

Article Information

Received: June 22, 2011
Accepted after revision: July 27, 2011
Published online: December 14, 2011
Number of Print Pages : 7
Number of Figures : 1, Number of Tables : 3, Number of References : 29

  

Publication Details

Fetal Diagnosis and Therapy (Clinical Advances and Basic Research)

Vol. 31, No. 1, Year 2012 (Cover Date: February 2012)

Journal Editor: Gratacós E. (Barcelona)
ISSN: 1015-3837 (Print), eISSN: 1421-9964 (Online)

For additional information: http://www.karger.com/FDT


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References

  1. Pilu G, Hobbins J: Sonography of fetal cerebrospinal anomalies. Prenat Diagn 2002;22:321-330.
  2. Achiron R, Schimmel M, Achiron A, Mashiach S: Fetal mild idiopathic lateral ventriculomegaly: is there a correlation with fetal trisomy? Ultrasound Obstet Gynecol 1993;3:89-92.
  3. Kelly EN, Allen VM, Seaward G, Windrim R, Ryan G: Mild ventriculomegaly in the fetus, natural history, associated findings and outcome of isolated mild ventriculomegaly: a literature review. Prenat Diagn 2001;21:697-700.
  4. Gaglioti P, Danelon D, Bontempo S, Mombrò M, Cardaropoli S, Todros T: Fetal cerebral ventriculomegaly: outcome in 176 cases. Ultrasound Obstet Gynecol 2005;25:372-377.
  5. Graham E, Duhl A, Ural S, Allen M, Blakemore K, Witter F: The degree of antenatal ventriculomegaly is related to pediatric neurological morbidity. J Matern Fetal Med 2001;10:258-263.
  6. Signorelli M, Tiberti A, Valseriati D, Molin E, Cerri V, Groli C, Bianchi UA: Width of the fetal lateral ventricular atrium between 10 and 12 mm: a simple variation of the norm? Ultrasound Obstet Gynecol 2004;23:14-18.
  7. Melchiorre K, Bhide A, Gika AD, Pilu G, Papageorghiou AT: Counseling in isolated mild fetal ventriculomegaly. Ultrasound Obstet Gynecol 2009;34:212-224.
  8. Falip C, Blanc N, Maes E, Zaccaria I, Oury JF, Sebag G, Garel C: Postnatal clinical and imaging follow-up of infants with prenatal isolated mild ventriculomegaly: a series of 101 cases. Pediatr Radiol 2007;37:981-989.
  9. Vergani P, Locatelli A, Strobelt N, Cavallone M, Ceruti P, Paterlini G, Ghidini A: Clinical outcome of mild fetal ventriculomegaly. Am J Obstet Gynecol 1998;178:218-222.
  10. Melchiorre K, Liberati M, Celentano C, Domizio S, Puglielli C, Buoni S, Strambi M, Zannolli R: Neurological outcome following isolated 10-12 mm fetal ventriculomegaly. Arch Dis Child Fetal Neonatal Ed 2009;94:F311-F312.
  11. Gaglioti P, Oberto M, Todros T: The significance of fetal ventriculomegaly: etiology, short- and long-term outcomes. Prenat Diagn 2009;29:381-388.

    External Resources

  12. International Society of Ultrasound in Obstetrics and Gynecology. Sonographic examination of the fetal central nervous system: guidelines for performing the ‘basic examination' and the ‘fetal neurosonogram'. Ultrasound Obstet Gynecol 2007;29:109-116.

    External Resources

  13. Newborg J, Stock JR, Wnek L: Batelle, inventario de desarrollo. Madrid, TEA, 2004.
  14. Berls AT; McEwen IR: Battelle Developmental Inventory. Phys Ther 1999;79:776-783.
  15. Newborg J, Stock JR, Wnek L, Guidubaldi J, Svinicki J: The Battelle Developmental Inventory. Allen, TX: DLM Teaching Resources; 1988.
  16. Salomon LJ, Bernard JP, Ville Y: Reference ranges for fetal ventricular width: a non-normal approach. Ultrasound Obstet Gynecol 2007;30:61-66.
  17. Arora A, Bannister CM, Russell S, Rimmer S: Outcome and clinical course of prenatally diagnosed cerebral ventriculomegaly. Eur J Pediatr Surg 1998;8(suppl 1):63-64.

    External Resources

  18. Pilu G, Falco P, Gabrielli S, Perolo A, Sandri F, Bovicelli L: The clinical significance of fetal isolated cerebral borderline ventriculomegaly: report of 31 cases and review of the literature. Ultrasound Obstet Gynecol 1999;14:320-326.
  19. Rydz D, Srour M, Oskoui M, Marget N, Shiller M, Birnbaum R, Majnemer A, Shevell MI: Screening for developmental delay in the setting of a community pediatric clinic: a prospective assessment of parent-report questionnaires. Pediatrics 2006;118:e1178-e1186.

    External Resources

  20. Glascoe FP, Byrne KE: The usefulness of the Battelle Developmental Inventory Screening Test. Clin Pediatr (Phila) 1993;32:273-280.
  21. Beeghly M, Ware J, Soul J, du Plessis A, Khwaja O, Senapati GM, Robson CD, Robertson RL, Poussaint TY, Barnewolt CE, Feldman HA, Estroff JA, Levine D: Neurodevelopmental outcome of fetuses referred for ventriculomegaly. Ultrasound Obstet Gynecol 2010;35:405-416.
  22. Bloom SL, Bloom DD, DellaNebbia C, Martin LB, Lucas MJ, Twickler DM: The developmental outcome of children with antenatal mild isolated ventriculomegaly. Obstet Gynecol 1997;90:93-97.
  23. Sadan S, Malinger G, Schweiger A, Lev D, Lerman-Sagie T: Neuropsychological outcome of children with asymmetric ventricles or unilateral mild ventriculomegaly identified in utero. Br J Obstet Gynaecol 2007;114:596-602.
  24. Reynolds AJ, Temple JA, Robertson DL, Mann EA: Long-term effects of an early childhood intervention on educational achievement and juvenile arrest: A 15-year follow-up of low-income children in public schools. JAMA 2001;285:2339-2346.
  25. Riethmuller AM, Jones R, Okely AD: Efficacy of interventions to improve motor development in young children: a systematic review. Pediatrics 2009;124:e782-e792.

    External Resources

  26. Ong L, Nolan RP, Irvine J, Kovacs AH: Parental overprotection and heart-focused anxiety in adults with congenital heart disease. Int J Behav Med 2010, DOI: 10.1007/s12529-010-9112-y.

    External Resources

  27. Vermaes IP, Gerris JR, Janssens JM: Parents' social adjustment in families of children with spina bifida: a theory-driven review. J Pediatr Psychol 2007;32:1214-1226.

    External Resources

  28. Chiappedi M, Bejor M: Corpus callosum agenesis and rehabilitative treatment. Ital J Pediatr 2010;36:64.

    External Resources

  29. Joó JG, Tóth Z, Beke A, Papp C, Tóth-Pál E, Csaba A, Szigeti Z, Rab A, Papp Z: Etiology, prenatal diagnostics and outcome of ventriculomegaly in 230 cases. Fetal Diagn Ther 2008;24:254-263.

    External Resources