Clinical Outcomes of Fetal Ventriculomegaly: A Retrospective Analysis from a Tertiary Referral Center

Danhua Guo,1,2 Shuqiong He,1,2 Na Lin,1,2 Yifang Dai,1,2 Ying Li,1,2 Liangpu Xu,1– 3 Xiaoqing Wu1– 4 1Department of Medical Genetic Diagnosis and Therapy Center, Fujian Maternity and Child Health Hospital College of Clinical Medicine for Obstetrics & Gynecology and Pediatrics, Fujian Medical University, Fuzhou, Fujian, People’s Republic of China; 2Fujian Provincial Key Laboratory of Prenatal Diagnosis and Birth Defect, Fuzhou, Fujian, People’s Republic of China; 3Department of Laboratory Medicine, Fujian Medical University, Fuzhou, Fujian, People’s Republic of China; 4Key Laboratory of Clinical Laboratory Technology for Precision Medicine (Fujian Medical University), Fujian Province University, Fuzhou, Fujian, People’s Republic of ChinaCorrespondence: Liangpu Xu; Xiaoqing Wu, Department of Medical Genetic Diagnosis and Therapy Center, Fujian Maternity and Child Health Hospital College of Clinical Medicine for Obstetrics & Gynecology and Pediatrics, 18 Daoshan Road, Gulou District, Fuzhou City, Fujian Province, 350001, People’s Republic of China, Email xiliangpu@fjmu.edu.cn; wuxiaoqing013@126.comObjective: To evaluate perinatal outcomes in fetal ventriculomegaly (VM).Methods: We retrospectively reviewed 720 pregnancies diagnosed with fetal ventriculomegaly (VM) between 2014 and 2018. Cases were classified as isolated ventriculomegaly (IVM, n = 451) or non-isolated ventriculomegaly (NIVM, n = 269) based on the presence of additional prenatal imaging abnormalities. According to the width of the lateral ventricles, VM was further categorized as mild (10– 11.9 mm, n = 555), moderate (12– 14.9 mm, n = 88), or severe (≥ 15 mm, n = 77). Serial prenatal ultrasound measurements were used to evaluate intrauterine progression, which was defined as regressive (≥ 2 mm decrease), stable (< 2 mm change), or progressive (≥ 2 mm increase) ventricular width. Periodic antenatal and postnatal imaging data were collected, and pregnancy outcomes were obtained through medical records and telephone follow-up.Results: Overall, favorable outcomes were observed in 93.75% of IVM cases, with rates of 95.31% in mild, 89.2% in moderate, and 25.0% in severe VM. In IVM cases, severe VM (OR = 60.214), intrauterine stability (OR = 5.687), and progression (OR = 34.88), were significantly associated with adverse outcomes. The NIVM group showed a significantly higher rate of pregnancy termination compared with the IVM group (39.5% vs 8.9%, p < 0.05). Among ongoing pregnancies, adverse outcomes were also more frequent in the NIVM group than in the IVM group (15.6% vs 6.25%, p < 0.05). Among cases with adverse outcomes, persistent intracranial imaging abnormalities were identified in 66.7% of NIVM cases and 57.1% of IVM cases.Conclusion: NIVM correlates with high termination/adverse outcome rates. VM severity intrauterine stability and progression are key risk factors, necessitating continuous imaging surveillance for optimal management.Keywords: ventriculomegaly, isolated ventriculomegaly, non-isolated ventriculomegaly, termination of pregnancy, pregnancy outcome