EP05.38: Prenatal and postnatal diagnosis of fetuses with severe ventriculomegaly: 20 years of experience in a tertiary centre

To describe the prenatal and postnatal diagnosis of fetuses with severe ventriculomegaly. This was observational, cross-sectional, retrospective, descriptive study conducted at INPer from January 2001 to April 2022. Patients with single pregnancy and a fetus diagnosed with severe ventriculomegaly were selected. They were divided into categories: isolated symmetric bilateral ventriculomegaly, non-isolated symmetric bilateral ventriculomegaly, isolated asymmetric bilateral ventriculomegaly, non-isolated asymmetric bilateral ventriculomegaly, isolated unilateral ventriculomegaly, and non-isolated unilateral ventriculomegaly. Prenatal diagnoses, complementary studies, postnatal diagnoses, and perinatal data were collected. Finally, a correlation was made between the prenatal and postnatal diagnoses. Over a period of 22 years, 206 cases of severe ventriculomegaly were diagnosed. The main cause of isolated symmetric bilateral ventriculomegaly was aqueductal stenosis of Sylvius (65.4%). Agenesis of the corpus callosum was the most common cause of isolated unilateral ventriculomegaly (20%). Non-isolated symmetric bilateral ventriculomegaly accounted for 37.3% of cases. Agenesis of the corpus callosum was the most common diagnosis in non-isolated asymmetric bilateral ventriculomegaly (24.3%). A total of 88 MRI studies were performed (42.7%), and 46.5% of them confirmed the diagnosis made by ultrasound. Out of the 206 patients included in the study, 194 were born alive, and at least one postnatal study was performed on 151 of them (73.4%). Finally, a total agreement of 59.6% was found between the main prenatal diagnostic suspicion and the final diagnosis in both groups. Fetal severe ventriculomegaly poses a challenges for the treating doctor, both in terms of diagnosis and follow-up, as well as obstetric management and parental counselling. It requires interdisciplinary evaluation and close monitoring, as the prognosis is considered uncertain until a diagnostic suspicion and possible associations are integrated.