Skip to main content
SpringerLink
Log in

Fetal Hydrocephalus and Its Treatment In Utero

  • Living reference work entry
  • First Online:
Textbook of Pediatric Neurosurgery

  • 319 Accesses

Abstract

Fetal hydrocephalus is a complex and multifactorial disease. The outcome of a fetus with hydrocephalus depends on the etiology and on its onset during the pregnancy. The fetal moment, characterized as the period during which the fetus suffers the insult culminating in hydrocephalus, is also one of the most important factors to consider when establishing a prenatal prognosis. Fetal hydrocephalus diagnosed in the last trimester of the gestation usually have a better outcome when compared with those that are diagnosed in the first and second trimester of the pregnancy; a similar behavior can be seen in the obstructive hydrocephalus that have a better outcome when compared with communicating hydrocephalus. Other malformations associated with hydrocephalus may occur in up to 75% of cases, providing a strong influence on the prognosis of fetuses affected by this disease.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution

Institutional subscriptions

References

  • Adzick NS, Thom EA, Spong CY, Brock JW, Burrows PK, Johnson MP, Howell LJ, Farrell JA, Dabrowiak ME, Sutton LN, Gupta N, Tulipan NB, D'Alton ME, Farmer DL, Investigators M (2011) A randomized trial of prenatal versus postnatal repair of myelomeningocele. N Engl J Med 364(11):993–1004. doi:10.1056/NEJMoa1014379

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Alter M (1962) Anencephalus, hydrocephalus, and spina bifida. Epidemiology, with special reference to a survey in Charleston, S.C. Arch Neurol 7:411–422

    Article  CAS  PubMed  Google Scholar 

  • Barke MW, Scarbough JI, O'Gorman L, Thompson WB Jr (1966) Intrauterine ventriculography of the hydrocephalic fetus. Obstet Gynecol 28(4):568–570

    CAS  PubMed  Google Scholar 

  • Birnholz JC, Frigoletto FD (1981) Antenatal treatment of hydrocephalus. N Engl J Med 304(17):1021–1023. doi:10.1056/NEJM198104233041706

    Article  CAS  PubMed  Google Scholar 

  • Brock DJ, Sutcliffe RG (1972) Alpha-fetoprotein in the antenatal diagnosis of anencephaly and spina bifida. Lancet 2(7770):197–199

    Article  CAS  PubMed  Google Scholar 

  • Bruner JP, Tulipan NB, Davis GH (2001) Open fetal surgery for nonlethal malformations. Infertil Reprod. Med Clin North Am 12:829–840

    Google Scholar 

  • Bulas D (2007) Fetal magnetic resonance imaging as a complement to fetal ultrasonography. Ultrasound Q 23(1):3–22. doi:10.1097/01.ruq.0000263841.69689.a7

    Article  PubMed  Google Scholar 

  • Buxton N, Macarthur D, Mallucci C, Punt J, Vloeberghs M (1998) Neuroendoscopic third ventriculostomy in patients less than 1 year old. Pediatr Neurosurg 29(2):73–76

    Article  CAS  PubMed  Google Scholar 

  • Cavalheiro S, Uchiyama M, Santana RM, Pares DBS, Rogano LA, Camano L, Braga FM (1992) Hidrocefalia fetal. J Bras Neurocirurg 3:1–8

    Google Scholar 

  • Cavalheiro S, Sparapani FV, Moron AF, da Silva MC, Stavale JN (2002) Fetal meningeal hemangiopericytoma. Case Rep J Neurosurg 97(5):1217–1220. doi:10.3171/jns.2002.97.5.1217

    Google Scholar 

  • Cavalheiro S, Moron AF, Zymberg ST, Dastoli P (2003) Fetal hydrocephalus – prenatal treatment. Childs Nerv Syst 19(7–8):561–573. doi:10.1007/s00381-003-0772-7

    Article  PubMed  Google Scholar 

  • Cavalheiro S, Lopez A, Serra S, Da Cunha A, da Costa MD, Moron A, Lederman HM (2016) Microcephaly and Zika virus: neonatal neuroradiological aspects. Childs Nerv Syst. doi:10.1007/s00381-016-3074-6

  • Chadduck WM, Seibert JJ (1989) Intracranial duplex Doppler: practical uses in pediatric neurology and neurosurgery. J Child Neurol 4(Suppl):S77–S86

    Article  PubMed  Google Scholar 

  • Chervenak FA, Duncan C, Ment LR, Hobbins JC, McClure M, Scott D, Berkowitz RL (1984) Outcome of fetal ventriculomegaly. Lancet 2(8396):179–181

    Article  CAS  PubMed  Google Scholar 

  • Clark RG, Milhorat TH (1970) Experimental hydrocephalus. 3. Light microscopic findings in acute and subacute obstructive hydrocephalus in the monkey. J Neurosurg 32(4):400–413. doi:10.3171/jns.1970.32.4.0400

    Article  CAS  PubMed  Google Scholar 

  • Clewell WH, Johnson ML, Meier PR, Newkirk JB, Zide SL, Hendee RW, Bowes WA Jr, Hecht F, O'Keeffe D, Henry GP, Shikes RH (1982) A surgical approach to the treatment of fetal hydrocephalus. N Engl J Med 306(22):1320–1325. doi:10.1056/NEJM198206033062202

    Article  CAS  PubMed  Google Scholar 

  • Cochrane DD, Myles ST, Nimrod C, Still DK, Sugarman RG, Wittmann BK (1985) Intrauterine hydrocepahlus associated abnormalities and fetal outcome. Can J Neurol Sci 12:51–59

    Article  CAS  PubMed  Google Scholar 

  • Coffey VP, Jessop WJ (1955) Congenital abnormalities. Ir J Med Sci 349:30–48

    Article  Google Scholar 

  • Edwards MS (1986) An evaluation of the in utero neurosurgical treatment of ventriculomegaly. Clin Neurosurg 33:347–357

    CAS  PubMed  Google Scholar 

  • Edwards MS, Harrison MR, Halks-Miller M, Nakayama DK, Berger MS, Glick PL, Chinn DH (1984) Kaolin-induced congenital hydrocephalus in utero in fetal lambs and rhesus monkeys. J Neurosurg 60(1):115–122. doi:10.3171/jns.1984.60.1.0115

    Article  CAS  PubMed  Google Scholar 

  • Frigoletto FD Jr, Birnholz JC, Greene MF (1982) Antenatal treatment of hydrocephalus by ventriculoamniotic shunting. JAMA 248(19):2496–2497

    Article  PubMed  Google Scholar 

  • Garel C (2005) Fetal cerebral biometry: normal parenchymal findings and ventricular size. Eur Radiol 15(4):809–813. doi:10.1007/s00330-004-2610-z

    Article  CAS  PubMed  Google Scholar 

  • Goh D, Minns RA, Pye SD (1991) Transcranial Doppler (TCD) ultrasound as a noninvasive means of monitoring cerebrohaemodynamic change in hydrocephalus. Eur J Pediatr Surg 1(Suppl 1):14–17. doi:10.1055/s-2008-1042529

    Article  PubMed  Google Scholar 

  • Gorayeb RP, Cavalheiro S, Zymberg ST (2004) Endoscopic third ventriculostomy in children younger than 1 year of age. J Neurosurg 100(5 Suppl):427–429. doi:10.3171/ped.2004.100.5.0427

    PubMed  Google Scholar 

  • Gosling H, King DH (1974) Continous wave ultrasound as an alternative and complement to X-ray in vascular examination. In: Reneman RS (ed) Cariovascular application of ultrasound. Elsevier, New York, pp 266–282

    Google Scholar 

  • Huisman TA (2008) Fetal magnetic resonance imaging. Semin Roentgenol 43(4):314–336. doi:10.1053/j.ro.2008.07.005

    Article  PubMed  Google Scholar 

  • Huisman TA (2011) Fetal magnetic resonance imaging of the brain: is ventriculomegaly the tip of the syndromal iceberg? Semin Ultrasound CT MR 32(6):491–509. doi:10.1053/j.sult.2011.08.002

    Article  PubMed  Google Scholar 

  • Huisman TA, Martin E, Kubik-Huch R, Marincek B (2002) Fetal magnetic resonance imaging of the brain: technical considerations and normal brain development. Eur Radiol 12(8):1941–1951. doi:10.1007/s00330-001-1209-x

    Article  PubMed  Google Scholar 

  • Jeanty P, Dramaix-Wilmet M, Delbeke D, Rodesch F, Struyven J (1981) Ultrasonic evaluation of fetal ventricular growth. Neuroradiology 21(3):127–131

    CAS  PubMed  Google Scholar 

  • Gupta J, Bryce FC, Lilford RJ (1995) Assessment and management of fetal ventriculomegaly and other associated congenital anomalies. In: Levene MI, Lilford RJ (eds) Fetal and neonatal neurology and neurosurgery, 2nd edn. Churchill Levingstone, Edinburgh, pp 215–230

    Google Scholar 

  • Kellner KR, Cruz AC, Gelman SR, Vries JK, Spellacy WN (1980) Percutaneous fetal ventriculography: a simplified technique to aid in management of the hydrocephalic fetus. J Reprod Med 24(5):225–228

    CAS  PubMed  Google Scholar 

  • Kelly EN, Allen VM, Seaward G, Windrim R, Ryan G (2001) Mild ventriculomegaly in the fetus, natural history, associated findings and outcome of isolated mild ventriculomegaly: a literature review. Prenat Diagn 21(8):697–700

    Article  CAS  PubMed  Google Scholar 

  • Kulkarni AV, Sgouros S, Constantini S, Investigators I (2016) International infant hydrocephalus study: initial results of a prospective, multicenter comparison of endoscopic third ventriculostomy (ETV) and shunt for infant hydrocephalus. Childs Nerv Syst 32(6):1039–1048. doi:10.1007/s00381-016-3095-1

    Article  PubMed  Google Scholar 

  • Liley AW (1963) Intrauterine transfusion of foetus in haemolytic disease. Br Med J 2(5365):1107–1109

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Lorber J (1961) Systematic ventriculographic studies in infants born with meningomyelocele and encephalocele. The incidence and development of hydrocephalus. Arch Dis Child 36:381–389

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Lui K, Hellmann J, Sprigg A, Daneman A (1990) Cerebral blood-flow velocity patterns in post-hemorrhagic ventricular dilation. Childs Nerv Syst 6(5):250–253

    Article  CAS  PubMed  Google Scholar 

  • Malpas P (1937) The incidence of human malformations and the significance of changes in the maternal enviroment in the causation. J Obstet Gynaecol Br Emp 44:434–438

    Article  Google Scholar 

  • Manning FA, Harrison MR, Rodeck C (1986) Catheter shunts for fetal hydronephrosis and hydrocephalus. Report of the International fetal surgery registry. N Engl J Med 315(5):336–340. doi:10.1056/NEJM198607313150532

    Article  CAS  PubMed  Google Scholar 

  • Michejda M, Hodgen GD (1981) In utero diagnosis and treatment of non-human primate fetal skeletal anomalies. I. Hydrocephalus. JAMA 246(10):1093–1097

    Article  CAS  PubMed  Google Scholar 

  • Michejda M, Queenan JT, McCullough D (1986) Present status of intrauterine treatment of hydrocephalus and its future. Am J Obstet Gynecol 155(4):873–882

    Article  CAS  PubMed  Google Scholar 

  • Milhorat TH (1978) Hydrocephalus. In: Plum F, McDowell FH (eds) Pediatric neurosurgery. F.A. Davis Company, Philadelphia, pp 91–135

    Google Scholar 

  • Nakayama DK, Harrison MR, Berger MS, Chinn DH, Halks-Miller M, Edwards MS (1983) Correction of congenital hydrocephalus in utero I. The model: intracisternal kaolin produces hydrocephalus in fetal lambs and rhesus monkeys. J Pediatr Surg 18(4):331–338

    Article  CAS  PubMed  Google Scholar 

  • Nicolaides KH, Berry S, Sniiders RJM, Thorpe-Beeston JG, Gosden C (1990) Fetal lateral cerebral ventriculomegaly: associated malformations and chromossomal defects. Fetal Diagn Ther 5:5–14

    Article  CAS  PubMed  Google Scholar 

  • Nishimaki S, Kawakami T, Akamatsu H, Iwasaki Y (1991) Cerebral blood flow velocities in the anterior cerebral arteries and basilar artery. III. Investigation in hydrocephalus (part 2). No To Hattatsu 23(6):560–566

    CAS  PubMed  Google Scholar 

  • Nomura ML, Barini R, De Andrade KC, Milanez H, Simoni RZ, Peralta CF, Machado IN, Zambelli H, Maio KT (2010) Congenital hydrocephalus: gestational and neonatal outcomes. Arch Gynecol Obstet 282(6):607–611. doi:10.1007/s00404-009-1254-2

    Article  PubMed  Google Scholar 

  • Oi S (2003) Diagnosis, outcome, and management of fetal abnormalities: fetal hydrocephalus. Childs Nerv Syst 19(7–8):508–516. doi:10.1007/s00381-003-0790-5

    Article  PubMed  Google Scholar 

  • Pooh RK, Maeda K, Pooh KH (2003) An atlas of fetal central nervous system disease. In: Diagnosis and management. Pathernon CRC, London

    Google Scholar 

  • Pooh RH, Pooh KH (2009) Antenatal assessment of CNS anomalies, including neural tube defects. In: Levene MI, Chervenak FA (eds) Fetal and neonatal neurology and neurosurgery, 4th edn. Elsevier, Edinburgh, pp 291–337

    Chapter  Google Scholar 

  • Pourcelot L (1974) Applications cliniques de L’examen Doppler transcutané. In: Peroneal P (ed) Velocimetre ultrasonore Doppler, vol 34. Inserm, Paris, pp 213–240

    Google Scholar 

  • Prata-Martins JA, Diegoli MSC, Diegoli CA, Neme B (1985) Conduta obstétrica e prognóstico da hidrocefalia. Ginecol Obstet Bras 8:195–201

    Google Scholar 

  • Seibert JJ, McCowan TC, Chadduck WM, Adametz JR, Glasier CM, Williamson SL, Taylor BJ, Leithiser RE Jr, McConnell JR, Stansell CA et al (1989) Duplex pulsed Doppler US versus intracranial pressure in the neonate: clinical and experimental studies. Radiology 171(1):155–159. doi:10.1148/radiology.171.1.2648468

    Article  CAS  PubMed  Google Scholar 

  • Stein SC, Feldman JG, Apfel S, Kohl SG, Casey G (1981) The epidemiology of congenital hydrocephalus. A study in Brooklyn, N.Y. 1968–1976. Childs Brain 8(4):253–262

    CAS  PubMed  Google Scholar 

  • Vintzileos AM, Campbell WA, Weinbaum PJ, Nochimson DJ (1987) Perinatal management and outcome of fetal ventriculomegaly. Obstet Gynecol 69(1):5–11

    CAS  PubMed  Google Scholar 

  • von Koch CS, Gupta N, Sutton LN, Sun PP (2003) In utero surgery for hydrocephalus. Childs Nerv Syst 19(7–8):574–586. doi:10.1007/s00381-003-0775-4

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Neurosurgery, Federal University of Sao Paulo, Sao Paulo, SP, Brazil

    Sergio Cavalheiro, Marcos Devanir Silva da Costa, Patricia Alessandra Dastoli, Jardel Mendonça Nicacio & Italo Capraro Suriano

  2. Department of Obstetrics, Federal University of Sao Paulo, Sao Paulo, SP, Brazil

    Antonio Fernandes Moron

Authors
  1. Sergio Cavalheiro
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Antonio Fernandes Moron
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Marcos Devanir Silva da Costa
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Patricia Alessandra Dastoli
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Jardel Mendonça Nicacio
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Italo Capraro Suriano
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Sergio Cavalheiro .

Editor information

Editors and Affiliations

  1. International Neuroscience Institute, Hannover, Germany

    Concezio Di Rocco

  2. Oakland Medical Center, Oakland, California, USA

    Dachling Pang

  3. University of Toronto Hospital for Sick Children, Toronto, Ontario, Canada

    James T. Rutka

Section Editor information

  1. Director of Pediatric Neurosurgery, International Neuroscience Institute, Hannover, Germany

    Concezio Di Rocco

  2. Pediatric Neurosurgery, Institute of Neurosurgery, Catholic University Medical School, Largo “A. Gemelli”,8, 00168, Rome, Italy

    Gianpiero Tamburrini

Rights and permissions

Reprints and permissions

Copyright information

© 2017 Springer International Publishing AG

About this entry

Cite this entry

Cavalheiro, S., Moron, A.F., da Costa, M.D.S., Dastoli, P.A., Nicacio, J.M., Suriano, I.C. (2017). Fetal Hydrocephalus and Its Treatment In Utero. In: Di Rocco, C., Pang, D., Rutka, J. (eds) Textbook of Pediatric Neurosurgery. Springer, Cham. https://doi.org/10.1007/978-3-319-31512-6_16-1

Download citation

  • DOI: https://doi.org/10.1007/978-3-319-31512-6_16-1

  • Received:

  • Accepted:

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-31512-6

  • Online ISBN: 978-3-319-31512-6

  • eBook Packages: Springer Reference Biomedicine and Life SciencesReference Module Biomedical and Life Sciences

Publish with us

Policies and ethics

Search

Navigation