Öykü TOSUN, Abdulkadir TURGUT, Özgür AYDIN, Vedat DAYICIOĞLU, Nazan TARHAN, Yusuf ÇAKMAK, Sevcan Arzu ARINKAN

Evaluation of fetal ventriculomegaly

Amaç: Fetal ventrikülomegali tanısı alan olguların prenatal, postnatal dönem takip ve tedavi sonuçlarını değerlendirmektir. Yöntemler: Lateral ventrikül boyutu 10mm ve üzerindeolan olgular çalışmaya dahil edildi. Toplam 69 olgu saptadık ancak bu olgulardan sekizi çalışmamıza katılmayıreddetti. Hastalar ek anomalisi olanlar (kombine ventrikülomegali) ve olmayanlar (izole ventrikülomegali) olarak2 gruba ayrıldı. Her grup lateral ventrikül boyutuna göre;hafif (10-12mm), orta (12,1-14,9 mm), ağır (15 mm veüzeri) 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 ventrikü- lomegalisi olan grupta sağ kalım %90 ve ağır ventrikülo- megalisi 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.

Fetal ventrikülomegalinin değerlendirilmesi

Objective: To evaluate the prenatal and postnatal followup, treatment and the outcome of the patients with ventriculomegaly.Methods: Patients with lateral cerebral ventricle size10mm and higher were included. 69 patients were considered but 8 patients refused to join our study. The pa-tients were divided into two groups as they had additionalanomalies (combined ventriculomegaly) or not (isolatedventriculomegaly). Each group was divided into threesubgroups according to their lateral cerebral ventricle sizeas mild (10-12 mm), moderate (12.1-4.9 mm), severe (15mm 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.

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