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Ultrasonographic evaluation of ventriculomegaly cases
Ventrikülomegali vakalarının ultrasonografik değerlendirilmesi

Hakan Kalaycı, Halis Özdemir, Çağrı Gülümser, Ayşe Parlakgümüş, Tayfun Çok, Ebru Tarım, Filiz Bilgin Yanık
2015 Perinatal Journal  
Özet: Ventrikülomegali vakalar›n›n ultrasonografik de¤erlendirilmesi Amaç: Baflkent Üniversitesi Adana ve Ankara Hastaneleri Perinatoloji bilim dal›nda tan› alm›fl veya ventrikülomegali ön tan›s› ile refere edilmifl hastalar›n demografik verilerinin retrospektif olarak de¤erlendirilmesi. Yöntem: Bu çal›flmada May›s 2008 ve Mart 2013 tarihleri aras›nda Baflkent Üniversitesi Ankara ve Adana Hastaneleri Perinatoloji Bilim Dal›na d›flar›dan gönderilen veya klini¤imizde tespit edilen fetal
more » ... len fetal ventrikülomegalisi olan 61 gebe demografik verileri, tan› konulma haftalar›, efllik eden anomaliler ve gebeliklerin seyri aç›s›ndan de¤erlendirildi. ‹statistiksel hesaplamalarda SPSS v. 16.0'dan faydalan›ld›. Bulgular: 20-41 yafl aras› 61 gebenin de¤erlendirmesinde, %45.9'unun ilk gebelikleriydi. %16.4'ü 35 yafl ve üzeriydi. %4.9'unun yard›mc› üreme teknikleri ile gebe kald›¤› izlendi. Hafif (10-12 mm), ›l›ml› (12.1-14.9 mm) ve ciddi ventrikülomegali (≥15 mm) oranlar› s›ras› ile %65.6, %24.7 ve %4.8 idi. Hiçbir vakada toksoplazma, sitomegalovirüs, rubella veya Herpes virüs enfeksiyonu saptanmad›. Karyotip analizinde 3 hastada Down sendromu tespit edildi (%4.9). Ventrikülomegalilerin %67.2'si tek ta-rafl› idi. Ayr›nt›l› ultrasonografi haftas› olan 16-24 haftalar› aras› tespit oran› %52.5 idi. %33.3 ek anomali mevcuttu. En s›k efllik eden anomaliler s›kl›k s›ras›na göre artm›fl nukal kal›nl›k (%13.3), korpus kallozum agenezisi (%11.1) ve nazal kemik hipoplazisi (%8.9) olarak izlendi. Takiplerde %53.8 vakada bulgular›n gerile-di¤i, %19.3'ünde ilerledi¤i ve %26.9'unda de¤iflmeden kald›¤› izlendi. Sonuç: Ventrikülomegali tespit edildi¤inde etyoloji araflt›rmas›nda ayr›nt›l› ultrasonografik muayene ile ek anomalilerin varl›¤› araflt›r›lmal›d›r. Selektif vakalarda ek serebral anomalileri de¤erlendirmek için manyetik rezonans görüntüleme yönteminden fay-dalan›labilir. Karyotip analizi ve toksoplazma, rubella, sitomegalovirüs ve Herpes virüs enfeksiyonlar›n›n araflt›r›lmas› ek anomali varl›¤›nda ve hatta izole vakalarda ventrikülomegalinin derecesi ne olursa olsun önerilmelidir. Hastalar düzenli takibe al›nmal›d›r. Anahtar sözcükler: ‹zole ventrikülomegali, ek anomaliler, takip. Abstract Objective: To evaluate retrospectively the demographic data of the patients diagnosed in or referred with the pre-diagnosis of ventriculomegaly to Perinatology Department of Adana and Ankara Hospitals of Baflkent University. Methods: In this study, 61 pregnant women with fetal ventriculomegaly diagnosed in our clinic or referred by other centers to the Perinatology Department of Ankara and Adana Hospitals of Baflkent University between May 2008 and March 2013 were evaluated in terms of their demographic data, diagnosis weeks, concomitant anomalies and the course of their pregnancies. SPSS v. 16.0 was used for statistical calculations. Results: The analysis of 61 pregnant women between 20 and 41 years old showed that it was the first pregnancy of 45.9% of them. Only 16.4% of them were at or over 35 years old. It was observed that 4.9% of them were conceived by assisted reproduction techniques. The rates of mild (10-12 mm), moderate (12.1-14.9 mm) and severe ventriculomegaly (≥15 mm) were 65.6%, 24.7% and 4.8%, respectively. Toxoplasma, Cytomegalovirus, Rubella or Herpes virus infections were not found in any case. Down syndrome was found in the karyotype analysis of 3 patients (4.9%). The ventriculomegaly was unilateral in 67.2% of the cases. The detection rate between 16 and 24 weeks which were also the weeks for detailed ultrasonography was 52.5%. There was an additional anomaly in 33.3% of the cases. The most frequent concomitant anomalies were found as increased nuchal thickness (13.3%), corpus callosum agenesis (11.1%) and nasal bone hypoplasia (8.9%). In their follow-ups, it was observed that the findings were regressed in 53.8% of the cases, progressed in 19.3% of the cases and remained unchanged in 26.9%. Conclusion: When ventriculomegaly is detected, the presence of additional anomalies should be investigated by detailed ultrasonographic examination during etiological investigation. In the selective cases, the physicians may utilize the method of magnetic resonance imaging to evaluate additional cerebral anomalies. It is also necessary to recommend karyotype analysis and investigating Toxoplasma, Rubella, Cytomegalovirus and Herpes virus infections in the presence of additional anomaly and even in isolated cases regardless of the level of ventriculomegaly. Patients should be followed up regularly.
doi:10.2399/prn.15.0231001 fatcat:ak3sk2usbze4xmjzuxwvbnaybe