Clinical Outcomes of Fetal Ventriculomegaly: A Retrospective Analysis from a Tertiary Referral Center.

Objective: To evaluate perinatal outcomes in fetal ventriculomegaly (VM). Methods: We retrospectively reviewed 720 pregnancies diagnosed with fetal ventriculomegaly (VM) between 2014 and 2018. Cases were classified as isolated ventriculomegaly (IVM, n = 451) or non-isolated ventriculomegaly (NIVM, n = 269) based on the presence of additional prenatal imaging abnormalities. According to the width of the lateral ventricles, VM was further categorized as mild (10-11.9 mm, n = 555), moderate (12-14.9 mm, n = 88), or severe (≥15 mm, n = 77). Serial prenatal ultrasound measurements were used to evaluate intrauterine progression, which was defined as regressive (≥2 mm decrease), stable (<2 mm change), or progressive (≥2 mm increase) ventricular width. Periodic antenatal and postnatal imaging data were collected, and pregnancy outcomes were obtained through medical records and telephone follow-up. Results: Overall, favorable outcomes were observed in 93.75% of IVM cases, with rates of 95.31% in mild, 89.2% in moderate, and 25.0% in severe VM. In IVM cases, severe VM (OR = 60.214), intrauterine stability (OR = 5.687), and progression (OR = 34.88), were significantly associated with adverse outcomes. The NIVM group showed a significantly higher rate of pregnancy termination compared with the IVM group (39.5% vs 8.9%, p < 0.05). Among ongoing pregnancies, adverse outcomes were also more frequent in the NIVM group than in the IVM group (15.6% vs 6.25%, p < 0.05). Among cases with adverse outcomes, persistent intracranial imaging abnormalities were identified in 66.7% of NIVM cases and 57.1% of IVM cases. Conclusion: NIVM correlates with high termination/adverse outcome rates. VM severity intrauterine stability and progression are key risk factors, necessitating continuous imaging surveillance for optimal management.