INTRAPARTUM MANAGEMENT OF SEVERE FETAL HYDROCEPHALY

The management of pregnant women with advanced hydrocephalic fetuses presents a dilemma for the treating physician. One side of the management scale is represented by termination of the pregnancy once the diagnosis is confirmed. On the other hand, pregnancy may be allowed to continue to term and vaginal delivery is achieved after performing destructive procedures to the baby's head, which may lead to significant maternal morbidity and definite fetal mortality. Three pregnant women with known severe hydrocephalic fetuses were managed by intraoperative ventriculocentesis to reduce the fetal head circumference prior to delivery by cesarean section in order to avoid any intra-patum destructive surgery on the fetal head. Results and follow-up of the three babies and their mothers are described.