Prevalence, natural history, and clinical outcome of mild to moderate ventriculomegaly

To estimate the prevalence, associated anomalies, progression, and clinical outcome in fetuses diagnosed with mild to moderate ventriculomegaly at 18-24 weeks of pregnancy. This was a prospective population-based study from the North of England. Data were extracted from the U.K. Northern Congenital...

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Veröffentlicht in:	Obstetrics and gynecology (New York. 1953) Jg. 117; H. 4; S. 867
Hauptverfasser:	Sethna, Farah, Tennant, Peter W G, Rankin, Judith, C Robson, Stephen
Format:	Journal Article
Sprache:	Englisch
Veröffentlicht:	United States 01.04.2011
Schlagworte:	Adult Cerebral Ventriculography - methods Chi-Square Distribution Cohort Studies Confidence Intervals Databases, Factual Female Fetal Death Fetal Development - physiology Gestational Age Humans Hydrocephalus - diagnostic imaging Hydrocephalus - epidemiology Hydrocephalus - physiopathology Infant, Newborn Neonatal Screening - methods Pregnancy Pregnancy Outcome Prenatal Care - methods Prenatal Diagnosis Prevalence Prospective Studies Risk Assessment Severity of Illness Index Statistics, Nonparametric United Kingdom Young Adult
ISSN:	1873-233X, 1873-233X
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Abstract	To estimate the prevalence, associated anomalies, progression, and clinical outcome in fetuses diagnosed with mild to moderate ventriculomegaly at 18-24 weeks of pregnancy. This was a prospective population-based study from the North of England. Data were extracted from the U.K. Northern Congenital Abnormality Survey for cases identified during 1994-2008. Additional anomalies present were categorized according to European Surveillance of Congenital Anomalies guidelines. Differences between isolated and nonisolated ventriculomegaly were examined by either Fisher's exact test or Mann-Whitney U test. Changes in prevalence were examined by the χ² test for trend. There were 355 cases of confirmed mild to moderate ventriculomegaly in singleton pregnancies at 18-24 weeks of gestation among 454,080 registered births, giving a total prevalence of 7.8 per 10,000 registered births (95% confidence interval [CI] 7.0-8.7). The minimum rate of chromosomal anomaly and trisomy 21 (including cases karyotyped postnatally) in isolated cases (ie, in which no other structural anomaly was identified prenatally) was 10.2% (95% CI 6.1-16.0) and 4.5% (95% CI 2.0-8.7), respectively. Additional structural anomalies were identified prenatally in 43.1% of cases. Among isolated cases, 61.9% (95% CI 53.3-70.0) resolved by the final prenatal scan (the majority by 24 weeks of gestation) and 10.7% (95% CI 6.4-16.6) were found to have "missed" structural anomalies after birth. The probability of an infant death for isolated ventriculomegaly was 3% (95% CI 0.8-7.6). This register-based study on mild to moderate ventriculomegaly provides unique epidemiologic and outcome data. Information from this study should aid in counseling parents. III.
AbstractList	To estimate the prevalence, associated anomalies, progression, and clinical outcome in fetuses diagnosed with mild to moderate ventriculomegaly at 18-24 weeks of pregnancy.OBJECTIVETo estimate the prevalence, associated anomalies, progression, and clinical outcome in fetuses diagnosed with mild to moderate ventriculomegaly at 18-24 weeks of pregnancy.This was a prospective population-based study from the North of England. Data were extracted from the U.K. Northern Congenital Abnormality Survey for cases identified during 1994-2008. Additional anomalies present were categorized according to European Surveillance of Congenital Anomalies guidelines. Differences between isolated and nonisolated ventriculomegaly were examined by either Fisher's exact test or Mann-Whitney U test. Changes in prevalence were examined by the χ² test for trend.METHODSThis was a prospective population-based study from the North of England. Data were extracted from the U.K. Northern Congenital Abnormality Survey for cases identified during 1994-2008. Additional anomalies present were categorized according to European Surveillance of Congenital Anomalies guidelines. Differences between isolated and nonisolated ventriculomegaly were examined by either Fisher's exact test or Mann-Whitney U test. Changes in prevalence were examined by the χ² test for trend.There were 355 cases of confirmed mild to moderate ventriculomegaly in singleton pregnancies at 18-24 weeks of gestation among 454,080 registered births, giving a total prevalence of 7.8 per 10,000 registered births (95% confidence interval [CI] 7.0-8.7). The minimum rate of chromosomal anomaly and trisomy 21 (including cases karyotyped postnatally) in isolated cases (ie, in which no other structural anomaly was identified prenatally) was 10.2% (95% CI 6.1-16.0) and 4.5% (95% CI 2.0-8.7), respectively. Additional structural anomalies were identified prenatally in 43.1% of cases. Among isolated cases, 61.9% (95% CI 53.3-70.0) resolved by the final prenatal scan (the majority by 24 weeks of gestation) and 10.7% (95% CI 6.4-16.6) were found to have "missed" structural anomalies after birth. The probability of an infant death for isolated ventriculomegaly was 3% (95% CI 0.8-7.6).RESULTSThere were 355 cases of confirmed mild to moderate ventriculomegaly in singleton pregnancies at 18-24 weeks of gestation among 454,080 registered births, giving a total prevalence of 7.8 per 10,000 registered births (95% confidence interval [CI] 7.0-8.7). The minimum rate of chromosomal anomaly and trisomy 21 (including cases karyotyped postnatally) in isolated cases (ie, in which no other structural anomaly was identified prenatally) was 10.2% (95% CI 6.1-16.0) and 4.5% (95% CI 2.0-8.7), respectively. Additional structural anomalies were identified prenatally in 43.1% of cases. Among isolated cases, 61.9% (95% CI 53.3-70.0) resolved by the final prenatal scan (the majority by 24 weeks of gestation) and 10.7% (95% CI 6.4-16.6) were found to have "missed" structural anomalies after birth. The probability of an infant death for isolated ventriculomegaly was 3% (95% CI 0.8-7.6).This register-based study on mild to moderate ventriculomegaly provides unique epidemiologic and outcome data. Information from this study should aid in counseling parents.CONCLUSIONThis register-based study on mild to moderate ventriculomegaly provides unique epidemiologic and outcome data. Information from this study should aid in counseling parents.III.LEVEL OF EVIDENCEIII. To estimate the prevalence, associated anomalies, progression, and clinical outcome in fetuses diagnosed with mild to moderate ventriculomegaly at 18-24 weeks of pregnancy. This was a prospective population-based study from the North of England. Data were extracted from the U.K. Northern Congenital Abnormality Survey for cases identified during 1994-2008. Additional anomalies present were categorized according to European Surveillance of Congenital Anomalies guidelines. Differences between isolated and nonisolated ventriculomegaly were examined by either Fisher's exact test or Mann-Whitney U test. Changes in prevalence were examined by the χ² test for trend. There were 355 cases of confirmed mild to moderate ventriculomegaly in singleton pregnancies at 18-24 weeks of gestation among 454,080 registered births, giving a total prevalence of 7.8 per 10,000 registered births (95% confidence interval [CI] 7.0-8.7). The minimum rate of chromosomal anomaly and trisomy 21 (including cases karyotyped postnatally) in isolated cases (ie, in which no other structural anomaly was identified prenatally) was 10.2% (95% CI 6.1-16.0) and 4.5% (95% CI 2.0-8.7), respectively. Additional structural anomalies were identified prenatally in 43.1% of cases. Among isolated cases, 61.9% (95% CI 53.3-70.0) resolved by the final prenatal scan (the majority by 24 weeks of gestation) and 10.7% (95% CI 6.4-16.6) were found to have "missed" structural anomalies after birth. The probability of an infant death for isolated ventriculomegaly was 3% (95% CI 0.8-7.6). This register-based study on mild to moderate ventriculomegaly provides unique epidemiologic and outcome data. Information from this study should aid in counseling parents. III.
Author	C Robson, Stephen Tennant, Peter W G Rankin, Judith Sethna, Farah
Author_xml	– sequence: 1 givenname: Farah surname: Sethna fullname: Sethna, Farah organization: From the Fetal Medicine Unit, Royal Victoria Infirmary, Newcastle upon Tyne, United Kingdom; and the Institute of Health and Society, Newcastle University, Newcastle upon Tyne, United Kingdom – sequence: 2 givenname: Peter W G surname: Tennant fullname: Tennant, Peter W G – sequence: 3 givenname: Judith surname: Rankin fullname: Rankin, Judith – sequence: 4 givenname: Stephen surname: C Robson fullname: C Robson, Stephen
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Snippet	To estimate the prevalence, associated anomalies, progression, and clinical outcome in fetuses diagnosed with mild to moderate ventriculomegaly at 18-24 weeks...
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SubjectTerms	Adult Cerebral Ventriculography - methods Chi-Square Distribution Cohort Studies Confidence Intervals Databases, Factual Female Fetal Death Fetal Development - physiology Gestational Age Humans Hydrocephalus - diagnostic imaging Hydrocephalus - epidemiology Hydrocephalus - physiopathology Infant, Newborn Neonatal Screening - methods Pregnancy Pregnancy Outcome Prenatal Care - methods Prenatal Diagnosis Prevalence Prospective Studies Risk Assessment Severity of Illness Index Statistics, Nonparametric United Kingdom Young Adult
Title	Prevalence, natural history, and clinical outcome of mild to moderate ventriculomegaly
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