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I. Hydrocephalus

Maria Michejda, MD; Gary D. Hodgen, PhD

JAMA. 1981;246(10):1093-1097.

Abstract
We describe the antenatal diagnosis and intrauterine treatment of hydrocephalus induced (corticosteroid teratism) in fetal rhesus monkeys. Diagnostic techniques included (1) maternal serum -fetoprotein (AFP) measurement, (2) ultrasonography of the fetal ventricular system, (3) roentgenography, and (4) fetoscopy. After measuring excessive intracranial CSF pressures in hydrocephalic fetuses, an indwelling prosthetic valve was devised—the hydrocephalic antenatal vent for intrauterine treatment (HAVIT). The HAVIT was surgically implanted in the fetal skull so that when CSF pressures exceeded 60 mm H₂O, the ports opened to vent CSF from the fetal ventricular system into the amniotic fluid. Whereas unaided hydrocephalic neonates seldom survived more than ten to 14 days, manifesting progressive muscular weakness and frequent seizures, fetal monkeys receiving the HAVIT demonstrated markedly superior postnatal development of motor skills and weight gain. Although additional laboratory studies are indicated, ultimately, clinical investigations combining early diagnosis and in utero insertion of the HAVIT or similar prosthesis may significantly enhance the prognosis of children in whom severe antenatal hydrocephalus develops.

(JAMA 1981;246:1093-1097)

Author Affiliations
From the Pregnancy Research Branch, National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, Md.

Footnotes
Reprint requests to Pregnancy Research Branch, Bldg 18, Room 101, National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, MD 20205 (Dr Hodgen).

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