Prenatal Ultrasound Diagnosis of Severe Bilateral Ventriculomegaly at 34 Weeks: A Case Report

Fetal cerebral ventricular dilatation, or ventriculomegaly, is a medical condition in which the cerebral ventricles are enlarged due to disruptions in cerebrospinal fluid circulation. It is primarily diagnosed through a routine obstetric ultrasound. Its etiologies are vast and are likely influenced by both genetic and non-genetic factors. It is classified into mild, moderate, or severe forms based on ventricular measurements, hence guiding prognosis and management. This case report details a case of fetal ventricular dilatation identified during routine obstetric ultrasound, when a 25-year-old woman came in for regular checkup of a 34-week pregnancy at the Radiology Department of Kampala International University Teaching Hospital (KIU-TH). Ultrasound was done and found an extensive ventricular dilation of both lateral ventricles (measuring 17.8 mm RT & 16.4 mm on the LT; values far above normal threshold) and the third ventricle, with displacement of brain matter inferiorly. No other structural anomalies were found in utero. Ultrasound remains a pivotal tool in the early detection and monitoring of ventriculomegaly. Key diagnostic parameters include lateral ventricle width and frontal sinus horn measurements. For further evaluation, a referral magnetic resonance imaging (MRI) was recommended to determine underlying causes and refine management strategies. Accurate ultrasound measurements are essential for the classification as well as for the management of fetal ventriculomegaly. Additionally, early detection and thorough evaluation improve outcomes, particularly when coupled with follow-up imaging and multidisciplinary care. Continued technological advancements are proving to further refine diagnostic capabilities and optimize patient outcomes.

Key Words: ventriculomegaly, prenatal ultrasound, cerebral ventricular dilatation, MRI, hydrocephalus