Fetal Cerebral Ventricular Asymmetry Without Dilation: A Systematic Review

Abstract

The aim of this systematic review was to investigate the outcomes of pregnancies with fetal cerebral lateral ventricle asymmetry without dilation. We conducted a comprehensive literature search in the Embase, Medline, and Web of Science databases until April 29, 2024, of observational cohort studies that reported fetal ventricular asymmetry without dilation detected on ultrasound or magnetic resonance imaging. Of the 150 studies identified, 6 met the inclusion criteria. Among the cases of non-dilated ventricular asymmetry, 36.8–46.2% progressed to ventriculomegaly on follow-up by neurosonography or magnetic resonance imaging. Additional findings in the central nervous system were observed in 5.5–10.5% of cases, while 7.6% had additional fetal body findings. Abnormal genetic findings were present in 5.1% of cases. Postnatal follow-up indicated no abnormal developmental findings during the first year of life. By the age of 9–11 years, lower writing speed was observed, yet verbal fluency scores were higher than in the general population. In conclusion, non-dilated ventricular asymmetry in fetuses showed the potential for progression to ventriculomegaly, and linkage to genetic abnormalities. Larger prospective studies are essential to fully elucidate the condition’s natural history and refine clinical management strategies.

Zusammenfassung

Das Ziel dieser systematischen Übersicht war es, den Ausgang von Schwangerschaften mit fetaler zerebraler Asymmetrie der Seitenventrikel ohne Erweiterung zu untersuchen. Wir führten eine umfassende Literaturrecherche in den Datenbanken Embase, Medline und Web of Science bis zum 29. April 2024 durch, in der Beobachtungskohorten-Studien gesucht wurden, die über Fälle mit fetaler Ventrikel-Asymmetrie ohne Erweiterung berichteten, die mittels Ultraschall oder Magnet-Resonanz-Tomografie festgestellt wurden. Von den 150 identifizierten Studien erfüllten 6 die Einschlusskriterien. Bei 36,8–46,2% der Fälle einer nicht dilatierten Ventrikel-Asymmetrie zeigte sich in der Folgeuntersuchung mittels Neurosonografie oder Magnet-Resonanz-Tomografie eine Ventrikulomegalie. In 5,5–10,5% der Fälle wurden zusätzliche ZNS-Auffälligkeiten beobachtet, während bei 7,6% weitere fetale anatomische Anomalien festgestellt wurden. In 5,1% der Fälle wurden genetische Erkrankungen diagnostiziert. Die postnatale Nachsorge ergab keine Hinweise auf Entwicklungsstörungen im ersten Lebensjahr. Im Alter von 9–11 Jahren wurde eine verlangsamte Geschwindigkeit beim Schreiben beobachtet, die Wortflüssigkeitswerte waren jedoch höher als in der Allgemeinbevölkerung. Zusammenfassend lässt sich sagen, dass eine fetale Ventrikel-Asymmetrie ohne Erweiterung ein potenzielles Risiko für eine spätere Ventrikulomegalie darstellt und im Zusammenhang mit genetischen Anomalien stehen kann. Umfangreichere prospektive Studien sind unerlässlich, um diese zerebrale Anomalie in vollem Umfang zu verstehen und die klinischen Behandlungsstrategien zu verfeinern.

Keywords

fetal neurology - lateral ventricles - developmental outcome - asymmetry

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