Outcome of fetal Vein Galen aneurysmal malformations: a systematic review and meta-analysis. (12th December 2022)

• Record Type: Journal Article
• Authors: D'Amico, Alice; Tinari, Sara; D'Antonio, Francesco; Rizzo, Giuseppe; Liberati, Marco; Vasciaveo, Lorenzo; Buca, Danilo
• Is Part Of: Journal of maternal-fetal & neonatal medicine. Volume 35:Number 25(2022)
• Page Start: 5312
• Page End: 5317
• Publication Date: 2022-12-12
• Subjects: Vein of Galen -- prosencephalic vein -- artero-venous malformation -- aneurysmal -- cardiomegaly -- ventriculomegaly -- hydrops; Obstetrics -- Periodicals; Perinatology -- Periodicals; Infants (Newborn) -- Diseases -- Periodicals; Neonatology -- Periodicals; 618.2
• DOI: 10.1080/14767058.2021.1878494
• Languages: English
• ISSNs: 1476-7058

Abstract

Abstract: Objectives: To report the outcome of fetuses with a prenatal diagnosis of Vein of Galen (VOG) malformation. Methods: PubMed and Embase databases were searched. Random effect meta-analysis of proportions was used to analyze the data. The outcomes explored were prenatal ultrasound findings, mortality, preterm birth (PTB), abnormal neurological outcome, associated findings detected at post-natal brain imaging, need for anticonvulsant therapy, and the rate of children free from neurological impairment. Random effect meta-analysis of proportions were used to analyze the data. Results: Eleven studies (226 fetuses with a prenatal diagnosis of VOG malformation) were included. All cases were detected during the third trimester of pregnancy. Ventriculomegaly was detected in 31.8% (95% CI 27.6–47.7), cardiomegaly or other ultrasound signs of cardiac compromise in 23.1% (95% CI 14.9–32.5) and hydrops in 7.3% (95% CI 2.8–13.6) of cases. The incidence of IUD, NND, and PND was 1.5% (95% CI 0.2–4.3), 23.8% (95% CI 16.9–31.4), and 24.5% (95% CI 17.6–32.2), respectively, while 12.6% (95% CI 6.0–21.2) of pregnancies were complicated by PTB. Abnormal neurodevelopmental outcome was observed in 36.7% (95% CI 27.9–39.7) of cases, while 60.5% (95% CI 17.0–82.0) of children had abnormal findings on post-natal imaging and only 29.7% (95% CI 23.3–36.5) were free from neurological impairment after birth, although there was a wide heterogeneity in the time at follow-up between the included studies. Conclusion: VOG malformation diagnoses during fetal life is associated with a high incidence of brain damage, cardiac compromise, and abnormal neurodevelopmental outcome after birth.