Document Detail


Neurodevelopmental outcome of fetuses referred for ventriculomegaly.
MedLine Citation:
PMID:  20069560     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To characterize the delivery and postnatal neurodevelopmental outcomes of fetuses referred for ventriculomegaly (VM).
METHODS: Under an internal review board-approved protocol, pregnant women were referred for magnetic resonance imaging (MRI) after sonographic diagnosis of VM and classified into one of four diagnostic groups: Group 1, normal central nervous system (CNS); Group 2, isolated mild VM (10-12 mm); Group 3, isolated VM > 12 mm; and Group 4, other CNS findings. Pregnancy outcome was obtained. Follow-up visits were offered with assessment of neurodevelopmental, adaptive and neurological functioning at 6 months and 1 year and/or 2 years of age. Atrial diameter and VM group differences in developmental outcomes were evaluated using repeated measures logistic regression and Fishers exact test, respectively.
RESULTS: Of 314 fetuses, 253 (81%) were liveborn and survived the neonatal period. Fetuses in Groups 4 and 3 were less likely to progress to live delivery and to survive the neonatal period (60% and 84%, respectively) than were those in Groups 2 or 1 (93% and 100%, respectively, P < 0.001). Of the 143 fetuses followed postnatally, between 41% and 61% had a Bayley Scales of Infant Development (BSID-II) psychomotor developmental index score in the delayed range (< 85) at the follow-up visits, whereas the BSID-II mental developmental index and Vineland Adaptive Behavior composite scores were generally in line with normative expectations. Among those that were liveborn, neither VM group nor prenatal atrial diameter was related to postnatal developmental outcome.
CONCLUSIONS: Diagnostic category and degree of fetal VM based on ultrasound and MRI measurements are associated with the incidence of live births and thus abnormal outcome. Among those undergoing formal postnatal testing, VM grade is not associated with postnatal developmental outcome, but motor functioning is more delayed than is cognitive or adaptive functioning.
Authors:
M Beeghly; J Ware; J Soul; A du Plessis; O Khwaja; G M Senapati; C D Robson; R L Robertson; T Y Poussaint; C E Barnewolt; H A Feldman; J A Estroff; D Levine
Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural    
Journal Detail:
Title:  Ultrasound in obstetrics & gynecology : the official journal of the International Society of Ultrasound in Obstetrics and Gynecology     Volume:  35     ISSN:  1469-0705     ISO Abbreviation:  Ultrasound Obstet Gynecol     Publication Date:  2010 Apr 
Date Detail:
Created Date:  2010-04-07     Completed Date:  2010-09-29     Revised Date:  2013-05-31    
Medline Journal Info:
Nlm Unique ID:  9108340     Medline TA:  Ultrasound Obstet Gynecol     Country:  England    
Other Details:
Languages:  eng     Pagination:  405-16     Citation Subset:  IM    
Copyright Information:
Copyright 2009 ISUOG. Published by John Wiley & Sons, Ltd.
Affiliation:
Department of Medicine, Beth Israel Deaconess Medical Center, Boston, MA 02215, USA.
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Cerebral Ventricles / pathology*,  ultrasonography
Child Development / physiology*
Developmental Disabilities* / etiology,  pathology
Dilatation, Pathologic / pathology,  ultrasonography
Female
Follow-Up Studies
Humans
Infant, Newborn
Magnetic Resonance Imaging / methods
Pregnancy
Pregnancy Outcome
Prospective Studies
Reproducibility of Results
Ultrasonography, Prenatal / methods
Young Adult
Grant Support
ID/Acronym/Agency:
R01 EB001998-10/EB/NIBIB NIH HHS
Comments/Corrections

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