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Małgorzata Świątkowska-Freund, Jerzy Wojculewicz, Jerzy Szczapa, Krzysztof Preis, Iwona Janczewska
Med Sci Monit 2004; 10(2): 97-101
Background: Congenital hydrocephalus is the cause of heavy mental and physical handicap in children. Technical advances in sonography have facilitated the diagnosis of hydrocephalus in utero. The aim of the study was to follow the further development of children born with hydrocephalus. Material/Methods: We performed a follow-up study of 30 infants born with congenital hydrocephalus between 1991 and 2001, in the Department of Obstetrics of the Medical University of Gdafsk. The analyzed group consisted of children who lived until the end of the observation period (till 28.02.2003). We analyzed the fetal age at diagnosis, the time of delivery and mode of delivery. Newborn’s clinical charts were reviewed for the newborn’s state after birth, birth weight, head circumference and the presence of clinical symptoms of hydrocephalus. We analyzed the cause of death, shunt placement after birth and status of living infants.Results: In the period of 1991–2001 the 22.534 births took place. Hydrocephalus was diagnosed in 30 newborns born alive or dead. Its’ incidence was 1.2 per 1000 of all births. Eighteen (60%) newborns were delivered vaginally and 12 of them (40%) by cesarean section. Nineteen (63.3%) newborns were born at term and 11 (36.7%) – before term. In 26 cases (86.6%) hydrocephalus was diagnosedin utero. Six children (20%) were still born. By the end of the observation period, 18 (60%) children died and 6 (20%) children survived. Factors influencing the rise of risk of death in these children were prematurity, the presence of other central nervous system malformations or that of other organs. In the group of 6 children that survived until the end of the study, 2 of them had not and the other four had present neurological abnormalities ranging from severe (paralysis and incontinence) to minimal defects.Conclusions: Congenital hydrocephalus is still associated with high newborn’s and older children’s death rate. The presence of other malformations of central nervous system, as well as of the other organs, has a negative impact on the survival rate of children with hydrocephalus.