Percutaneous fetal endoscopic third ventriculostomy for severe isolated cerebral ventriculomegaly

Prenat Diagn. 2023 Dec;43(13):1614-1621. doi: 10.1002/pd.6465. Epub 2023 Nov 8.

Abstract

Objective: To demonstrate the feasibility and preliminary results of percutaneous fetal endoscopic third ventriculostomy (ETV) in human fetuses (pfETV) with isolated progressive and/or severe bilateral cerebral ventriculomegaly (IPSBV).

Methods: The initial results of pfETV for IPSBV were described. Perioperative, perinatal and postnatal variables were described. The Ages and Stages Questionnaire (ASQ-3), 3rd edition (ASQ-3) was used for follow-up of all infants.

Results: Successful pfETV was performed in 10/11 (91%) fetuses, at a median gestational age (GA) of 28.7 weeks (25.3-30.7). There were no perioperative complications. After pfETV, 70% (7/10) of the fetuses had a decreased or stabilized lateral ventricle atria|lateral ventricle's atria. The median GA at delivery was 38.2 weeks (35.9-39.3). There were no perinatal complications. The postnatal ventriculoperitoneal shunt rate was 80% (8/10). Among neonates/infants who had prenatal stabilization or a decrease in the LVAs, 4 (4/7: 57.1%) had abnormal scores on the ASQ-3. Among neonates/infants that experienced prenatal increases in the LVAs, all of them (3/3: 100%) had abnormal scores on the ASQ-3.

Conclusion: Percutaneous ETV is feasible in human fetuses with progressive and/or severe cerebral ventriculomegaly and seems to be a safe procedure for both the mother and the fetus.

MeSH terms

  • Female
  • Fetus / surgery
  • Humans
  • Hydrocephalus* / complications
  • Hydrocephalus* / diagnostic imaging
  • Hydrocephalus* / surgery
  • Infant
  • Infant, Newborn
  • Pregnancy
  • Retrospective Studies
  • Third Ventricle* / diagnostic imaging
  • Third Ventricle* / surgery
  • Treatment Outcome
  • Ventriculostomy / adverse effects
  • Ventriculostomy / methods