Abstract

OBJECTIVES: The majority of the studies have focused on the perinatal and long-term outcomes in fetuses with antenatal diagnosis of bilateral ventriculomegaly. The aim of this study was to undertake a systematic review and meta-analysis to quantify the perinatal and long-term outcome of fetuses diagnosed with isolated unilateral ventriculomegaly during the second- or third- trimester of pregnancy. METHODS: Medline, and Embase and The Cochrane Library were searched electronically. The outcomes investigated included incidence of aneuploidy, congenital infections, progression, associated brain and extra-brain abnormalities for the apparently isolated unilateral ventriculomegaly cases and neurodevelopmental delay for both apparently and truly isolated unilateral ventriculomegaly cases. Sensitivity analysis was performed according to whether the ventriculomegaly was mild or severe. Reference lists of relevant articles and reviews were hand-searched for additional reports. Cohort and case-control studies were included. Meta-analyses of proportions were used. Between-study heterogeneity was assessed using the I(2) test. RESULTS: The search yielded 2053 citations. Full text was retrieved for 202 and the 11 studies were included in the systematic review. In fetuses with apparently isolated unilateral ventriculomegaly there were no chromosomal abnormalities and the rate of congenital infections was 8.2% (95% CI 3.6-14.5). The prevalence of MRI-detected additional brain abnormalities prenatally and postnatally was 5% (95% CI, 0.2-16) and 6.4%, (95% CI, 0.3-19.4), respectively. The incidence of abnormal neurodevelopmental status in apparently isolated cases measuring <15 mm was 5.9% (95% CI, 2.2-11.2), while it was 7.0% (95% CI, 3.2-12.2) in fetuses with truly isolated unilateral ventriculomegaly. Most of the cases reported (93%) were mild ventriculomegaly, and therefore the outcomes were similar to those above. CONCLUSIONS: The prevalence of aneuploidy, congenital infections and neurodevelopmental delay in fetuses with a prenatal diagnosis of isolated unilateral ventriculomegaly is likely to be low.