EC Gynaecology

Objective: To compare the prenatal progression, associated anomalies, and perinatal outcomes between fetuses with mild (10-12 mm) and moderate (13-15 mm) ventriculomegaly (VM).

Methods: A retrospective cohort study was conducted on fetuses diagnosed with mild or moderate VM at a single tertiary center between October 2014 and January 2018. Maternal and neonatal clinical data were collected from electronic medical records. Participants were divided into two groups (Mild vs. Moderate VM) for comparison. Statistical analysis was performed using Wizard Pro, with a p-value < 0.05 considered significant.

Results: Among 46 included cases, the median ventricular measurement was 10.5 mm for the mild group (n = 24) and 14.1 mm for the moderate group (n = 21). Non- CNS anomalies were significantly more common in the moderate group (57.1% vs. 24%, p = 0.02). A clinically important trend showed that nearly half (47%) of moderate VM cases progressed to severe VM, compared to 17% of mild cases (p = 0.06). Neonatal death occurred exclusively in the moderate VM group (27.8% vs. 0%, p = 0.007). The rates of CNS anomalies, intrauterine growth restriction (IUGR), and NICU admission were not significantly different between the groups.

Conclusion: Moderate fetal ventriculomegaly carries a significantly higher risk of associated non-CNS anomalies, progression to severe ventriculomegaly, and neonatal mortality compared to the mild form. While mild VM generally follows a more benign course, vigilant fetal and neonatal follow-up is warranted. These findings are crucial for accurate prenatal counseling and prognostication.

 Keywords: Ventriculomegaly; Hydrocephalus; Fetal Brain; Prenatal Diagnosis; Neurodevelopment; Congenital Anomalies; Retrospective Study

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