Introduction: Ventriculomegaly is one of the most common abnormalities detected by prenatal ultrasound. This entity can be associated with brain abnormalities and other malformations. In order to perform a good prenatal counseling, the diagnosis is essential. Objective: Our purpose was to report the management of 3 cases of ventriculomegaly in our practice and underline the benefits of the neuropathologic exam. Methods: We analyzed retrospectively 3 medical files concerning fetus that were diagnosed as having one or two ventricles of >10 mm and a follow up for prenatal diagnosis. Results: All cases were diagnosed between 22 and 27 weeks of gestation by an ultrasound. In a case, the ventriculomegaly evolved rapidly to a hydrocephalus. In two cases, the pregnancy was terminated with medical interruption by the parent’s request. Amniocentesis confirmed the diagnosis of congenital toxoplasmosis in case 2 there were no chromosomal abnormalities after karyotyping. Causes included holoprosencephaly, congenital toxoplasmosis and mesencephalosynapsis. Conclusion: Ultrasonography may detect ventriculomegaly nerverthless in the cases presented, pathology exam was essential to assess the diagnostic. Causes are numerous and prognosis variable. We recommand MRI that is more and more accessible in our regions in the follow up of this entity and neuropathology exam in case of termination of the pregnancy. The establishment of main causes of ventriculomegaly in our regions (infectious causes for example) could help to prevent this outcome in our practice.
References
[1]
Guibaud, L. (2009) Fetal Cerebral Ventricular Measurement and Ventriculomegaly: Time for Procedure Standardization. Ultrasound in Obstetrics & Gynecology, 34, 127-130. https://doi.org/10.1002/uog.6456
[2]
Pretorius, D.H., Drose, J.A. and Manco-johnson, M.L. (1986) Fetal Lateral Ventricular Ratio Determination during the Second Trimester. Journal of Ultrasound in Medicine, 5, 121-124. https://doi.org/10.7863/jum.1986.5.3.121
[3]
Cardoza, J.D., Goldstein, R.B. and Filly, R.A. (1988) Exclusion of Fetal Ventriculomegaly with a Single Measurement: The Width of the Lateral Ventricular Atrium. Radiology, 169, 711-714. https://doi.org/10.1148/radiology.169.3.3055034
[4]
Gangbo, F., Lokossou, A., Biaou, O., Lalèyè, A., Sossou, R., Carles, D., Alberti, E.M. and Darboux, R. (2006) About a Case of Alobar Holoprosencephaly Associated with a Probosis and an Atrioventricular Communication. Journal de la Société de Biologie Clinique, N° 010, 5-9.
[5]
Darouich, S., Boutaud, L., Bessières, B., Bonnière, M., Martinovic, J., Mechler, C., Alby, C., Bernard, J.P., Roth, P., Ville, Y., Malan, V., Vekemans, M., Attié-Bitach, T. and Encha-Razavi, F. (2017) Fetal Cerebral Ventricular Dilatation: Etiopathogenic Study of 130 Observations. Birth Defects Research, 109, 1586-1595. https://doi.org/10.1002/bdr2.1093
[6]
Briard, M.L., Feingold, J., Bonaiti-Pellie, C., Lapeyre, F., Frézal, J. and Varangot, J. (1975) Frequency of Birth Defects. Archives Françaises de Pédiatrie, 32, 123-138.
[7]
Poaty, H., Gentien, D., Reyes, C. and Silou, J. (2016) Macroscopic Analysis of Fetus Having Arhinencephaly, Synophtalmia and Holoprosencephaly. Human Genetics & Embryology, 6, 135. https://doi.org/10.4172/2161-0436.1000135
[8]
Launay, S., Cuilleret, V., Boyer, C., Mestdagh, P., Moisan, S., Vaast, P., Bourgeot, P., Denes, M., Rocourt, N. and Robert, Y. (2003) Magnetic Resonance Imaging Applications in obstetrics. Journal de Gynécologie Obstétrique et Biologie de la Reproduction (Paris), 32, 205-220.
[9]
Dia, A.A., D’Almeida, F., Mbodji, M., et al. (2013) Case Report: Alobar Holoprosencephaly in a Context of Polymalformative Syndrome: Contribution of Imaging, about a Case. Pan African Medical Journal, 15, 83.
[10]
Den Hollander, N.S., Vinkestijn, A., Schmitz-Van Plunder, P., Catsman-Berrevoets, C.E. and Wladimiroff, J.W. (1998) Prenatally Diagnosed Fetal Ventriculomegaly; Prognosis and Outcome. Prenatal Diagnosis, 18, 557-566. https://doi.org/10.1002/(SICI)1097-0223(199806)18:6<557::AID-PD303>3.3.CO;2-V
[11]
Valat, A.S., Dehouck, M.B., Dufour, P., et al. (1998) Fetal Ventriculomegaly. Etiology and Becoming, about 141 Observations. Journal de Gynécologie Obstétrique et Biologie de la Reproduction, 27, 782-789.
[12]
Benacerraf, B.R. (2001) Unilateral Cerebral Ventriculomegaly. Is One Better than Two? Journal of Ultrasound in Medicine, 20, 179-181. https://doi.org/10.7863/jum.2001.20.3.179
[13]
Body, G., Perrotin, F., Guichet, A., Paillet, C. and Descamps, P. (2001) The Practice of Prenatal Diagnosis. éd Masson, Paris, 288-289.
[14]
Cotty, F., Carpentier, M.A., Descamps, P., Perrotin, F. and Richard-Lenoble, D. (1997) Congenital Toxoplasmosis with Hydrocephalus: Prenatal Diagnosis and Developmental Outcome in a Treated Child. Archives de Pédiatrie, 4, 247-250. https://doi.org/10.1016/S0929-693X(97)87240-5
[15]
Nizard, J. (2008) Toxoplasmosis and Pregnancy. Journal de Gynécologie Obstétrique et Biologie de la Reproduction, 37, F4-F9. https://doi.org/10.1016/S0368-2315(08)70497-6
[16]
Hornoy, P., Mezzetta, L. and Adamsbaum, C. (2011) Prenatal Detection of Brain Anomalies with Ultrasonography. Journal of Radiology, 92, 111-117. https://doi.org/10.1016/j.jradio.2010.12.003
[17]
Razavi, F. and Carles, D. (2008) Fetal and Placental Pathology Practice, Ouvrage Collectif de la société française de foetopathologie. Sauramps Médical, Maisons-Alfort, 163-169.
[18]
Pasquier, L., Marcorelles, P., Loget, P., Pelluard, F., Carles, D., Perez, M.J., Bendavid, C., de La Rochebrochard, C., Ferry, M., David, V., Odent, S. and Laquerrière, A. (2009) Rhombencephalosynapsis and Related Anomalies: A Neuropathological Study of 40 Fetal Cases. Acta Neuropathologica, 117, 185-200. https://doi.org/10.1007/s00401-008-0469-9
[19]
Severino, M., Righini, A., Tortora, D., Pinelli, L., Parazzini, C., Morana, G., Accorsi, P., Capra, V., Paladini, D. and Rossi, A.M.R. (2017) Imaging Diagnosis of Diencephalic-Mesencephalic Junction Dysplasia in Fetuses with Developmental Ventriculomegaly. American Journal of Neuroradiology, 38, 1643-1646. https://doi.org/10.3174/ajnr.A5245
[20]
Kehila, M., Halouani, A., Touhami, O., Abouda, H.S., Khlifi, A., Hmid, R.B., Benhassen, I., Masmoudi, A. and Chanoufi, M.B. (2016) Confrontation between Ultrasound and Fetopathological Examination Following Therapeutic Abortion Performed in a Maternity Clinic in Tunisia. Pan African Medical Journal, 25, 256. https://doi.org/10.11604/pamj.2016.25.256.10011
[21]
Ferguson, D.J., Bowker, C., Jeffery, K.J., Chamberlain, P. and Squier, W. (2013) Congenital Toxoplasmosis: Continued Parasite Proliferation in the Fetal Brain Despite Maternal Immunological Control in Other Tissues. Clinical Infectious Diseases, 56, 204-208. https://doi.org/10.1093/cid/cis882
