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November 19, 1982

Antenatal Treatment of Hydrocephalus by Ventriculoamniotic Shunting

JAMA. 1982;248(19):2496-2497. doi:10.1001/jama.1982.03330190060034

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