Our long experience with prenatal diagnosis and planning for optimum care allows us to offer the highest quality treatment whether intervention is indicated before or after birth.
Under the direction of Dr. Michael Harrison, the Fetal Treatment Center was the first institution to develop fetal surgery techniques. The first open fetal surgery in the world was performed at UCSF since the early 1980's. We presently have more experience with fetal surgery and endoscopic fetal intervention (FETENDO fetal surgery) than any other institution in the world. We are dedicated to fetal research and treatment innovation.
The two components of the central nervous system are the brain and the spinal cord. The entire surface of the brain and spine cord is bathed by a clear, colorless fluid called cerebrospinal fluid (CSF). Cerebrospinal fluid is a clear, watery liquid that surrounds the brain and spinal cord, and is also found throughout the ventricle (brain cavities and tunnels). CSF cushions the brain and spinal cord from jolts.
Ventriculomegaly is when the fluid filled structures (lateral ventricles) in the brain are too large. When you are pregnant you will have an ultrasound. With the ultrasound the doctor will look at your fetus’s brain and measure the ventricles. If the lateral ventricles are 10 millimeters or greater in size then you will be told that your fetus has ventriculomegaly. Sometimes the ultrasound will only show one of the ventricles even though there are two (one on the right, and one on the left side). Ventriculomegaly seems to occur more often in male fetuses than in female fetuses.
The outcome of ventriculomegaly depends on several factors including the actual size of the ventricles, whether or not there are any other findings on the ultrasound, such as agenesis of the corpus callosum, and the results of the amniocentesis. In general, the outcome is worse when the ventricles are larger, the amniocentesis is abnormal, or there are other problems seen on the ultrasound. The best outcome is typically observed when the fetus' ventricles are only mildly enlarged (measure between 10-15 millimeters in size), and when there are no other problems seen on the ultrasound, and when genetic testing results are normal—this is called “Isolated Mild Ventriculomegaly”.
The exact outcome for your child’s health is difficult to know. The most common effect in the child is developmental delay. This seems to be related to the size of the ventricles. We are now studying Fetal MRI to see if the information from the Fetal MRI can tell us the chance of disability and can provide families with more information on what to expect for their child's health and development. This information will help parents make decisions during pregnancy and prepare in advance for challenges their child and the family may face.
If your doctor sees ventriculomegaly, they may refer you for several tests. These include a more detailed ultrasound (often times called “Level II ultrasound” or “Fetal Survey”), amniocentesis (to look at the genetic makeup of your fetus, and to look for any signs of infection), and fetal magnetic resonance imaging (Fetal MRI).
Fetal MRI is another way to safely look at your fetus’s brain. It gives pictures of your fetus’s brain using different technology than ultrasound. Because it uses a different technology, fetal MRI can detect other problems in your fetus’s brain that cannot be detected on ultrasound. We can then look at the results from all of the tests together and your physician can speak with you about the significance of these test results.
For more information on Fetal MRI please visit UCSF Baby Brain - Fetal MRI
There is no treatment before birth for fetuses with ventriculomegaly. Treatment after birth involves managing the child's symptoms. It is important during your pregnancy to get a detailed diagnosis (via detailed ultrasound, amniocentesis, and MRI) in order to determine if there are any additional problems. Our staff can talk to you about these test results and inform you what challenges you may expect. If there is evidence of more severe handicaps which require long-term care, we can help direct you to the appropriate specialists.
Baby Sarah Elizabeth has a very successful recovery from an SCT which is removed while she is still a fetus.