Antenatal Treatment of Hydrocephalus by Ventriculoamniotic Shunting

WE HAVE previously shown that serial percutaneous cephalocenteses could be accomplished safely with continuous ultrasound guidance.¹ This method provides only transient relief of elevated intracranial pressure because of prompt fluid reaccumulation. It is apparent that a continuous form of decompression will be required for effective antenatal treatment of hydrocephalus. Percutaneous placement of an indwelling ventriculoamniotic shunt is described.

Report of a Case  A 24 1/2-week-old male fetus was referred by his mother's obstetrician when an ultrasound examination obtained to resolve an apparent size-date disparity at 23 weeks of gestation disclosed fetal hydrocephalus. The mother was a 34-year-old, gravida 4 para 3. Had the option of terminating the pregnancy been available, it would have been unacceptable to both parents. After a thorough discussion with emphasis on the experimental nature of the procedure, they requested that maternal transabdominal ventriculoamniotic shunt placement be attempted.Further ultrasound examination confirmed symmetrical ventricular dilatation. Communication