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| CASE REPORT |
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| Year : 1991 | Volume
: 37
| Issue : 1 | Page : 49-50 |
Ultrasound guided cephalocentesis (USGC) (report of 2 cases).
Patel VH, Merchant SA, Kedar RP, Bhatt DC, Desa G
Department of Radiology, K.E.M. Hospital, Parel, Bombay, Maharashtra.
Correspondence Address:
Department of Radiology, K.E.M. Hospital, Parel, Bombay, Maharashtra.
How to cite this article:
Patel V H, Merchant S A, Kedar R P, Bhatt D C, Desa G. Ultrasound guided cephalocentesis (USGC) (report of 2 cases). J Postgrad Med 1991;37:49-50 |
How to cite this URL:
Patel V H, Merchant S A, Kedar R P, Bhatt D C, Desa G. Ultrasound guided cephalocentesis (USGC) (report of 2 cases). J Postgrad Med [serial online] 1991 [cited 2023 Jun 6];37:49-50. Available from: https://www.jpgmonline.com/text.asp?1991/37/1/49/803 |
Hydrocephalus is one of the most common congenital anomalies, with an incidence of 0.3 to 0.8 per 1000 births[1]. Sono-graphic prenatal diagnosis is easily accomplished utilising standard diagnostic criteria[4],[5]. Cephalocentesis under ultrasound guidance (USGC) is a technique that can be utilised to drain the excessive CSF. We report here 2 cases of USGC in gross hydrocephalus, performed mainly to facilitate normal vaginal delivery. The indications and the technique of this procedure are also offered.
Two cases of fetal hydrocephalus were encountered. In both there was gross dilatation of the lateral ventricles and the third ventricle with a normal posterior fossa, suggestive of aqueductal stenosis. Both fetuses were at term, one was in obstructed labour and the other was being evaluated for the cause of post-datism. The consequences of the severe hydrocephalus and the advantages of USGC were explained to parents who opted for cephalocentesis. USGC was performed under local anaesthesia with the use of a 20G L. P. needle utilising the font-anelles as the entry point. No problems were noted during or after the procedure with a normal vaginal delivery in both. However, both fetuses were stillborn.
The purpose of performing such an inter-ventional procedure was to aid in an uncomplicated vaginal delivery and thereby obviate the risk of caesarian section or vaginal delivery of a non-drained hydrocephalic fetus. This simple relatively non-invasive procedure obviates the use of manoeuvres performed vaginally which usually require perforation of the fetal head by various instruments[2],[3]. In addition, such manoeuvres also require dilated cervix, cephalic presentation and are much more traumatic than USGC
USGC is recommended as the procedure of choice in cases of gross fetal hydrocephalus with severe cortical loss. The fetal prognosis is terribly poor anyway and this procedure obviates the need for performing a caesarian section and helps in increasing the chances of an uncomplicated vaginal delivery.
| 1. |
Habib Z. Genetics and genetic counselling in neonatal hydrocephalus. Obstet Gynecol Surv 1981; 36:529-533.  |
| 2. | Oxorn H. In: "Oxorn-Foote Human Labour and Birth." 5th Edition. Nor walk, Connecticut: Appleton-Century-Crofts; 1986, pp 896-897. |
| 3. | Pereival R. In: "Holland & Brews, Manual of obstetrics." 14th Edition. New Delhi: BI Churchill Living stone Pvt Ltd; 1980, pp 500-504". |
| 4. | Pilu G, Bovicelli L. In: "Sono-graphy of the Fetal Cranium, Diagnosis and Therapy of Fetal Anomalies." JC Hobbins, BR Benacerraf, editors. 1st Edition. New York, USA: Churchill Living stone; 1989, pp 223-230. |
| 5. | Romero R, Pilu G, Ghidini A, Hobbins JC. In, "Prenatal Diagnosis of Congenital Anomalies." 1st Edition. Connecticut, USA: Appleton and Lange; 1988, pp 21-24.
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