In the ultrasound examination of the fetal head, in the second and third screening studies, attention is always paid to the structure of the brain and the size of the ventricles of the brain.
Ventriculomegaly of the lateral ventricles in the fetus - what is it?
In the norm there are 4 ventricles of the brain. In the thickness of the white substance of the brain there are two of them - the lateral ventricles of the brain, each of which has anterior, posterior and lower horn. With the help of the interventricular orifice, they connect to the third ventricle, and it connects the water pipe of the brain to the fourth ventricle located at the bottom of the rhomboid fossa. The fourth, in turn, is connected to the central canal of the spinal cord. This is a system of connected vessels with liquor. Normally, the size of the lateral ventricles of the brain is estimated, the size of which should not exceed 10 mm at the level of the hindbusts. The expansion of the ventricles of the brain is called ventriculomegaly.
Ventriculomegaly in the fetus - causes
Expansion of the ventricles of the brain, first of all, may be a consequence of the developmental abnormality of the central nervous system (CNS). The vice can be either isolated (only the nervous system), or be combined with other malformations of organs and systems, as is often the case with chromosomal diseases.
Another common cause of ventriculomegaly is viral and microbial infections of the mother. Especially dangerous are cytomegalovirus infection and toxoplasmosis , although any virus or microbe can cause developmental defects of the brain, ventriculomegaly and hydrocephalus. Possible causes of ventriculomegaly include trauma to the mother and fetus.
Diagnosis of fetal ventriculomegaly
In contrast to fetal hydrocephalus, ventriculomegaly dilates the ventricles of the brain more than 10 mm, but less than 15 mm, while the size of the fetal head does not increase. Diagnose ventriculomegaly by ultrasound, starting at 17 weeks. It can be asymmetric isolated (expansion of one ventricle or one of its horns), symmetrical isolated without other defects, or to be combined with other malformations of the brain and other organs. With isolated ventriculomegaly, concomitant chromosomal abnormalities, such as Down's syndrome, occur in 15-20%.
Ventriculomegaly in the fetus - consequences
Moderate ventriculomegaly in a fetus with a size of the lateral ventricles of up to 15 mm, especially with appropriate treatment, may not have any negative consequences. But if the ventricular size exceeds 15 mm, the hydrocephalus of the fetus begins to grow, then the consequences can be very different - from congenital CNS diseases to fetal death.
The earlier and faster the increase in ventriculomegaly with the transition to hydrocephalus, the worse the predictions. And in the presence of vices in other organs, the risk of having a child with a chromosomal abnormality (Down syndrome, Patau or Edwards syndrome) increases. Intrauterine fetal death or death during labor with ventriculomegaly is up to 14%. Normal development after childbirth without disrupting the CNS is possible only in 82% of surviving children, in 8% of children
Ventriculomegaly in the fetus - treatment
Medicamentous treatment of ventriculomegaly is aimed at reducing cerebral edema and the amount of fluid in the ventricles (diuretics). To improve the nutrition of the fetal brain, antihypoxants and vitamins are prescribed, especially the B group.
In addition to medicamental treatment, mothers are recommended to spend more time in the fresh air, therapeutic physical training aimed at strengthening the muscles of the pelvic floor.