Hidrocefalia intra-uterina

Thirty-twocases of intra-uterine hydrocephalus diagnosed at the Department of Obstetrics of Escola Paulista de Medicina, Sao Paulo, Brazil, from 1978 to 1990 were reviewed: the population under study included 1,987 partus with a prevalence of 2.66 cases per 1,000 births. No age difference could be observed between mothers of hydrocephalic babies and the other mothers, although primigravidas showed to be more frequently affected; "conceptus" were classified into two groups, with 17 cases retrospectively analysed (group A) and 15 prospectively (group B), all of them based in an inter disciplinary protocol. Cesarean sections were frequently performed - group A, 53% and group B, 93% with no sex predominance. Most of the cases were diagnosed after 32 weeks of gestation (62.5%) and the main cause of hydrocephalus was cerebral aqueduct compromise. Nine intra-uterine procedures were carried on (two in group A and seven in group B); a ventriculo-amniotic shunt was performed in only one case and repeated cephalocenteses in another. Births by vaginal delivery showed a mortality rate of 88.9%, while in cesarean sections it was 21.72%. Fetal hydrocephalus represents a very serious problem, with high prevalence in our milieu, so an interdisciplinary work is fundamental for the study and management of this pathology.