{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,23]],"date-time":"2026-08-23T17:42:36Z","timestamp":1787506956489,"version":"build-2736575974"},"reference-count":33,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2021,12,6]],"date-time":"2021-12-06T00:00:00Z","timestamp":1638748800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Prenatal Diagnosis"],"published-print":{"date-parts":[[2022,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Severe fetal ventriculomegaly (VM) is defined as an enlargement of the atria of the lateral cerebral ventricles (Vp) of greater than 15\u00a0mm. While it is well established that it confers significant risk of morbidity and mortality to the neonate, there is limited information pertaining to the caesarean delivery rates and the obstetric management of these complex cases. The aim of this study was twofold: firstly, to determine survival rates in fetuses with severe VM, and secondly to determine the caesarean delivery rates in continuing pregnancies. We explore the obstetric challenges associated with these difficult cases.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This was a prospective observational study of patients with antenatal severe VM, attending the Department of Fetal Medicine, National Maternity Hospital, Dublin, Ireland, from 1st January 2011 to 31st July 2020. Data were obtained from the hospital database and those with severe VM (Vp\u00a0&gt;\u00a015\u00a0mm) were identified. The rates of chromosomal abnormalities, the survival rates and the caesarean delivery (CD) rates for the overall group were then determined. The data were then further sub\u2010divided into two groups: 1. Vp\u00a0&lt;\u00a020\u00a0mm and 2. Vp\u00a0&gt;\u00a020\u00a0mm, and the results compared. Statistical analysis was performed using the Chi\u2010Square test.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      A total of\n                      <jats:italic>N<\/jats:italic>\n                      \u00a0=\u00a095 pregnancies with severe VM were included for analysis, of which additional structural abnormalities on ultrasound were apparent in 67\/95 (70.5%) and 28\/95 (29.5%) had isolated severe VM. Chromosomal abnormalities were diagnosed in 15\/95 (15.8%) of cases, with (2\/28) 7.1% in the isolated SVM group versus (13\/67) 19.4% in the non\u2010isolated SVM group. The overall survival rate (excluding TOP) was 53\/74 (71.6%), with 20\/23 (86.9%) in the isolated SVM group. The overall CD rate was 47\/72 (65.3%), which was significantly higher than the CD for the hospital during the same time period of 25.4% (\n                      <jats:italic>P<\/jats:italic>\n                      \u00a0&lt;\u00a00.01).\n                    <\/jats:p>\n                    <jats:p>\n                      The data were subdivided into Vp\u00a0&lt;\u00a020 and Vp\u00a0&gt;\u00a020 and those with a Vp\u00a0&gt;\u00a020 had higher rates of additional intracranial findings on ultrasound (Vp\u00a0&lt;\u00a020 13\/41 (31.7%) versus Vp\u00a0&gt;\u00a020 32\/54 (59.3%) (\n                      <jats:italic>P<\/jats:italic>\n                      \u00a0&lt;\u00a00.05)) and macrocrania (Vp\u00a0&lt;\u00a020 14\/41 (34.1%) versus Vp\u00a0&gt;\u00a020 35\/54 (64.8%) (\n                      <jats:italic>P<\/jats:italic>\n                      \u00a0&lt;\u00a00.05)). No significant difference was observed in the overall survival or CD rates between the two groups.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>In conclusion this study reports significant fetal morbidity and mortality with severe VM with high CD rates observed in this cohort. Significant challenges exist in relation to the obstetric management and counseling of parents regarding an often uncertain neonatal prognosis. In continuing pregnancies with significant macrocrania delivery plans should be individualized to improve neonatal outcomes where possible and minimize harm to the mother.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/pd.6072","type":"journal-article","created":{"date-parts":[[2021,12,6]],"date-time":"2021-12-06T09:40:32Z","timestamp":1638783632000},"page":"109-117","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["Severe fetal ventriculomegaly: Fetal morbidity and mortality, caesarean delivery rates and obstetrical challenges in a large prospective cohort"],"prefix":"10.1002","volume":"42","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0317-5642","authenticated-orcid":false,"given":"Alex O.","family":"Start","sequence":"first","affiliation":[{"name":"UCD Perinatal Research Centre University College Dublin The National Maternity Hospital  Dublin Ireland"},{"name":"Fetal Medicine Department The National Maternity Hospital  Dublin Ireland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gillian A.","family":"Ryan","sequence":"additional","affiliation":[{"name":"UCD Perinatal Research Centre University College Dublin The National Maternity Hospital  Dublin Ireland"},{"name":"Fetal Medicine Department The National Maternity Hospital  Dublin Ireland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Barbara","family":"Cathcart","sequence":"additional","affiliation":[{"name":"Fetal Medicine Department The National Maternity Hospital  Dublin Ireland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Heather","family":"Hughes","sequence":"additional","affiliation":[{"name":"Fetal Medicine Department The National Maternity Hospital  Dublin Ireland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shane","family":"Higgins","sequence":"additional","affiliation":[{"name":"UCD Perinatal Research Centre University College Dublin The National Maternity Hospital  Dublin Ireland"},{"name":"Fetal Medicine Department The National Maternity Hospital  Dublin Ireland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Siobhan","family":"Corcoran","sequence":"additional","affiliation":[{"name":"UCD Perinatal Research Centre University College Dublin The National Maternity Hospital  Dublin Ireland"},{"name":"Fetal Medicine Department The National Maternity Hospital  Dublin Ireland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jennifer","family":"Walsh","sequence":"additional","affiliation":[{"name":"UCD Perinatal Research Centre University College Dublin The National Maternity Hospital  Dublin Ireland"},{"name":"Fetal Medicine Department The National Maternity Hospital  Dublin Ireland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephen","family":"Carroll","sequence":"additional","affiliation":[{"name":"Fetal Medicine Department The National Maternity Hospital  Dublin 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