Donald School Journal of Ultrasound in Obstetrics and Gynecology

Register      Login

VOLUME 5 , ISSUE 2 ( April-June, 2011 ) > List of Articles


Mild Fetal Ventriculomegaly: Diagnostic Work-up and Management

Vincenzo Pinto, Angela Cristina Rossi

Keywords : Mild ventriculomegaly,Fetus,Ultrasound,Prenatal

Citation Information : Pinto V, Rossi AC. Mild Fetal Ventriculomegaly: Diagnostic Work-up and Management. Donald School J Ultrasound Obstet Gynecol 2011; 5 (2):119-126.

DOI: 10.5005/jp-journals-10009-1186

License: CC BY-NC 4.0

Published Online: 01-03-2012

Copyright Statement:  Copyright © 2011; The Author(s).


Mild ventriculomegaly (VM), also defined as “borderline”, is a condition characterized by an atrial width between 10 and 15 mm independently from gestational age.

Fetuses with mild ventriculomegaly require an accurate morphological examination to rule out for associated neural and extraneural anomalies. The percentage of this association is 41%. However, in almost 13% of cases, the associated anomaly is not recognized at the time of the initial presentation. It is important to monitor the atrial width during the third trimester because in 15% of the cases it increases. Most of the cases missed at the first examination have a late onset diseases (migrational disorders, parenchimal damage, hemorrhage, etc). For these conditions MRI may play a useful role.

Maternal serum tests for congenital infections should be performed, since infections may be the cause of mild VM in 1.5% of the cases.

Fetal karyotype should also be evaluated, since chromosomal abnormalities may be associated in 2.8% of the cases of isolated VM.

The counseling in cases of apparently isolated mild VMs focuses on the possibility of neurodevelopmental delay in the surviving infants. The average percentage of neurodevelopmental delay reported in the literature is 10.9%. The possibility of late onset brain anomalies must be considered.

In conclusion, the most important prognostic factors are the association with other abnormalities not detected at the first examination and the progression of the ventricular dilatation.

PDF Share
  1. AIUM practice guideline for the performance of an antepartum obstetrica ultrasound examination. L Ultrasound Medic 2003;22:116-25.
  2. Sonograpic examination of the fetal central nervous system: Guidelines for performing the “basic examination” and the “fetal neurosonogram”. Ultrasound Obstet Gynecol 2007;29:109-16.
  3. Exclusion of fetal ventriculomegaly with a single measurement: The width of the lateral ventricle atrium. Radiology 1988;169:711-14.
  4. Fetal cerebral ventricular measurement and ventriculomegaly: Time for procedure standardization. Ultrasound Obstet Gynecol 2009;34:127-30.
  5. The clinical significance of fetal isolated cerebral borderline ventriculomegaly: Report of 31 cases and review of the literature. Ultrasound Obstet Gynecol 1999;14:320-26.
  6. Width of the fetal lateral ventricular atrium between 10 and 12 mm: A simple variation of the norm? Ultrasound Obstet Gynecol 2004;23:14-18.
  7. Mild fetal lateral cerebral ventriculomegaly: Clinical course and outcome. Am J Obstet Gynecol 1991;164:863-67.
  8. Distal lateral ventricular atrium: Re-evaluation of normal range. Radiology 1994;193:405-08.
  9. Fetal mild idiopathic lateral ventriculomegaly: Is there a correlation with fetal trisomy? Ultrasound Obstet Gynecol 1993;3:89-92.
  10. Outcome of prenatally diagnosed mild unilateral cerebral ventriculomegaly. J Ultrasound Med 2001;20:257-62.
  11. Counseling in isolated mild fetal ventriculomegaly. Ultrasound Obstet Gynecol 2009;34:212-24.
  12. Prognosis of isolated mild to moderate fetal cerebral ventriculomegaly: A systematic review. J Perinat Med 2010;38:401-09.
  13. Clinical outcome of mild fetal ventriculomegaly. Am J Obstet Gynecol 1998;178:218-22.
  14. Isolated mild fetal cerebral ventriculomegaly: Clinical course and outcome. Radiology 1994;192:759-64.
  15. Mild lateral cerebral ventricular dilatation in utero: Clinical significance and prognosis. Radiology 1990;176:237-42
  16. Isolated mild fetal cerebral ventriculomegaly: A retrospective analysis of 26 cases. Prenat Diagn 2001;21:589-95.
  17. Obstetric and neonatal outcomes in apparently isolated mild fetal ventriculomegaly. J Perinat Med 2005;33: 236-40.
  18. The significance of fetal ventriculomegaly: Etiology, short-and long-term outcomes. Prenat Diagn 2009;29:381-88.
  19. The value of in utero magnetic resonance imaging in ultrasound diagnosed foetal isolated cerebral ventriculomegaly. Clin Radiol 2007;62:140-44.
  20. The role of ultrasonography in recognizing the cause of fetal cerebral ventriculomegaly. J Perinat Med 2004;32:5-12.
  21. Cavum veli interpositi cyst: Prenatal diagnosis and postnatal outcome. Ultrasound Obstet Gynecol 2009;34:52-54.
  22. The developmental outcome of children with antenatal mild isolated ventriculomegaly. Obstet Gynecol 1997;90:93-97.
  23. Prenatally diagnosed fetal ventriculomegaly: Prognosis and outcome. Prenat Diagn 1998;18:557-66.
  24. Outcome of fetuses with isolated borderline unilateral ventriculomegaly diagnosed at mid-gestation. Ultrasound Obstet Gynecol 1998;12:23-26.
  25. Prenatal diagnosis and follow-up of 14 cases of unilateral ventriculomegaly. Ultrasound Obstet Gynecol 1999;14:327-32.
  26. Mild ventriculomegaly as a counselling challenge. Fetal Diagn Ther 2001;16:398-401.
  27. Prenatal isolated mild ventriculomegaly: Outcome in 167 cases. BJOG 2006;113: 1072-79.
  28. Third-trimester fetal MRI in isolated 10-to 12 mm ventriculomegaly: Is it worth it? BJOG 2006;113: 942-47.
  29. What does magnetic resonance imaging add to the prenatal sonographic diagnosis of ventriculomegaly? J Ultrasound Med 2007;26: 1513-22.
  30. Prenatal diagnosis of congenital cytomegalovirus infection in 189 pregnancies with known outcome. Prenat Diagn 2001;21:362-77.
  31. Sonographic findings in fetal viral infections: A systematic review. Obstet Gynecol Surv 2006;61:329-36.
  32. Ultrasound markers of fetal infection (Part 1): Viral infections. Ultrasound Q 2005;21:295-308.
  33. Ultrasound markers of fetal infection (Part 2): Bacterial, parasitic and fungal infections. Ultrasound Q 2006;22:137-51.
  34. Comparison between ultrasound and magnetic resonance imaging in assessment of fetal cytomegalovirus infection. Prenat Diagn 2008;28:753-58.
  35. Neonatal alloimmune thrombocytopenia: Antenatal and postnatal imaging findings in the pediatric brain. AJNR Am J Neuroradiol 2002;23:1457-65.
  36. Diagnostic Imaging Committee, Society of Obstetricians and Gynaecologists of Canada; Genetics Committee, Society of Obstetricians and Gynaecologists of Canada: Fetal soft markers in obstetric ultrasound. J Obstet Gynaecol Can. J Obstet Gynaecol Can 2005;27:592-636.
  37. Isolated mild ventriculomegaly: Associated karyotypic abnormalities and in utero observations. J Matern Fetal Med 1997;6:241-44.
  38. In utero progression of mild fetal ventriculomegaly. Int J Gynaecol Obstet 2006;93:106-09.
PDF Share
PDF Share

© Jaypee Brothers Medical Publishers (P) LTD.