Evaluation of fetal ventriculomegaly

Öz

Objective: To evaluate the prenatal and postnatal follow up, treatment and the outcome of the patients with ven­triculomegaly. Methods: Patients with lateral cerebral ventricle size 10mm and higher were included. 69 patients were con­sidered but 8 patients refused to join our study. The pa­tients were divided into two groups as they had additional anomalies (combined ventriculomegaly) or not (isolated ventriculomegaly). Each group was divided into three subgroups according to their lateral cerebral ventricle size as mild (10-12 mm), moderate (12.1-4.9 mm), severe (15 mm and more) ventriculomegaly. Results: 10 fetuses with isolated ventriculomegaly and combined ventriculomegaly died after birth. Neurosurgi­cal operations were performed for ten patients. We per­formed chromosomal analysis for 16.7% of our patients. Caesarian delivery was higher (91.7%) in combined ven­triculomegaly groups and all newborns went to NNICU. In isolated ventriculomegaly group 18 patients showed nor­mal neurological development at sixth month. None of the patients with combined ventriculomegaly group showed normal neurological development at sixth month. In se­vere ventriculomegaly group termination ratio was higher (64.7%) than isolated ventriculomegaly group (11%). The survival rate was 90% in mild ventriculomegaly group and 42.9% in severe ventriculomegaly group. Conclusion: Termination is more often in isolated severe ventriculomegaly than mild and moderate ventriculomeg­aly group because the prognosis is worse. Because the prognosis of the patients with mild ventriculomegaly is good decision for termination will be well evaluated with the family. J Clin Exp Invest 2013; 4 (2): 141-147

Anahtar Kelimeler

• Prenatal diagnosis, growth & development, prognosis

Fetal ventrikülomegalinin değerlendirilmesi

Öz

Amaç: Fetal ventrikülomegali tanısı alan olguların prena­tal, postnatal dönem takip ve tedavi sonuçlarını değerlen­dirmektir. Yöntemler: Lateral ventrikül boyutu 10mm ve üzerinde olan olgular çalışmaya dahil edildi. Toplam 69 olgu sap­tadık ancak bu olgulardan sekizi çalışmamıza katılmayı reddetti. Hastalar ek anomalisi olanlar (kombine ventri­külomegali) ve olmayanlar (izole ventrikülomegali) olarak 2 gruba ayrıldı. Her grup lateral ventrikül boyutuna göre; hafif (10-12mm), orta (12,1-14,9 mm), ağır (15 mm ve üzeri) ventrikülomegali olarak alt gruplara ayrıldı. Bulgular: İzole ve kombine ventrikülomegalisi olan 10 fetus doğumdan sonra öldü. Onhastaya cerrahi tedavi uygulandı. Hastaların %16.7\'sine kromozomal analiz ya­pıldı. Kombine ventrikülomegalisi olan grupta sezaryen oranı yüksek bulundu(%91.7) ve bu gruptaki hastaların tümü Yenidoğan Yoğun Bakım Ünitesi\'ne (YYBÜ) yatış gerektirdi. İzole ventrikülomegalisi olan grupta vaginal doğum daha yüksek bulundu(%45.7). İzole ventrikülomegalisi olan grupta 18 olgu (%78.3) 6. ayda normal nörolojik gelişim gösterirken kombine vent­rikülomegalisi olan grupta hiçbir hastada 6. ayda normal nörolojik gelişim izlenmedi. Ağır ventrikülomegalisi olan grupta terminasyon oranı (%64.7) izole ventrikülomegalisi olan gruptan (%11) daha yüksek bulundu. Hafif ventrikü­lomegalisi olan grupta sağ kalım %90 ve ağır ventrikülo­megalisi olan grupta %42.9 olarak saptandı. Sonuç: Ağır ventrikülomegalisi olanlarda terminasyon oranı; hafif ve orta ventrikülomegalisi olan gruplardan daha sık gözlendi. Bunun nedeni ağır ventrikülomegalisi olan hastalarda prognozun çok daha kötü olmasıdır. İnt­rauterin fetal hafif izole ventrikülomegalisi olan olgularda prognoz oldukça iyi olduğundan terminasyon kararının hasta ile iyice irdelenmesi gerektiğini düşünmekteyiz.

Anahtar Kelimeler

• Prenatal tanı, büyüme ve gelişme, prognoz

Kaynakça

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