Hydrocephalus is a condition where excess fluid builds up in the brain, sometimes affecting babies before birth. If you're expecting and have concerns about hydrocephalus, this blog is here to empower you with knowledge. We'll explore the causes of hydrocephalus in pregnancy, how it's diagnosed, and the monitoring process throughout your pregnancy.  We'll also address treatment options during pregnancy, your baby's potential prognosis, and the long-term effects after delivery.  Finally, while there's no guaranteed prevention, we'll discuss steps you can take to feel more informed and prepared.  Let's navigate this journey together and find the answers you need for a healthy pregnancy.

Why do Babies Develop Hydrocephalus?

Babies develop hydrocephalus, known as congenital hydrocephalus when present at birth, due to a combination of genetic and environmental factors during fetal development. The main causes of congenital hydrocephalus include:

- Aqueductal stenosis

- Brain malformations

- Spina bifida

These factors play a role in the development of hydrocephalus in babies.

Related Blog: Preventing Pediatric Hydrocephalus: Steps for a Healthy Pregnancy

How is Hydrocephalus Diagnosed in Pregnancy?

Diagnosing hydrocephalus during pregnancy involves using ultrasound examinations, which are typically conducted at various stages of gestation. Here's how the diagnosis process works:

- Ultrasound screenings are the primary method for detecting hydrocephalus in the developing fetus. Technicians look for pockets of fluid in the brain, indicating enlarged ventricles and potential hydrocephalus.

- Hydrocephalus can be identified as early as the latter part of the first trimester, with diagnosis even possible at 13 weeks. By 20 to 24 weeks, the abnormal dilation of ventricles becomes more apparent.

- In certain cases where abnormal anatomy is suspected, fetal MRI may be recommended. This imaging technique provides detailed brain images beyond what ultrasound can offer.

By utilizing ultrasound and, when necessary, MRI, healthcare providers can diagnose hydrocephalus in the developing fetus, allowing for appropriate management and care.

Monitoring Hydrocephalus in Pregnancy

Hydrocephalus in pregnancy is typically monitored by regularly performing ultrasounds to observe the fetus. Unfortunately, there are no specific treatments available for this condition while the baby is still in the womb.

Throughout the pregnancy, it is crucial to conduct a series of ultrasounds to track the size of the ventricles in the baby's brain. It is unpredictable whether the ventricular size will increase or decrease in subsequent examinations.

In cases where the ventricular size remains stable, it is generally recommended to continue monitoring the fetus until full term.

To enhance the baby's outcome, it is advisable to delay delivery until the fetus reaches optimal maturity. Additionally, healthcare providers will assess whether a vaginal delivery is feasible or if a cesarean section is necessary based on the baby's head size.

Remember, the key is to prioritize the baby's well-being and make informed decisions based on medical advice.

If the ventricles of the fetus continue to enlarge, there are several options to consider:

- For fetuses younger than 32 weeks, it is important to balance the risk of lung immaturity with the potential harm of progressive ventriculomegaly.

- In cases of spina bifida diagnosis, surgical options before or after birth may be considered to close the baby's back. 

- For fetuses older than 35 weeks, a preterm cesarean section might be recommended, followed by the placement of a shunt after birth.

Related Blog: Pediatric Hydrocephalus Surgery: Exploring Treatment Options

Early establishment of a relationship with a pediatric neurosurgeon is crucial once hydrocephalus is suspected during pregnancy. Timely treatment may be necessary after the baby is born. The pediatric neurosurgeon will offer specific details and recommend the most suitable treatment for your child.

How is Hydrocephalus Managed and Treated During Pregnancy?

During pregnancy, hydrocephalus is typically managed through close observation. Currently, there are no treatments available specifically for the fetus. The medical team will closely monitor the fetus for any signs of distress, which could indicate the need for an early delivery. The goal is to delay delivery until the baby is as mature as possible to improve the outcome. The timing of delivery will be determined by the mother, her prenatal care provider, and the recommendations from the NJ Pediatric Neurosciense institute team.

What is the Prognosis for Babies with Hydrocephalus?

Hydrocephalus prognosis in babies offers hope for a fulfilling life, even though the path may differ from your expectations. Despite initial challenges, babies with hydrocephalus often grow into strong and determined individuals.

How Does Hydrocephalus Affect My Baby After Delivery?

Hydrocephalus can have various effects on a baby after delivery, making a thorough evaluation crucial. This evaluation typically involves imaging studies like CT, MRI, or ultrasound, as well as a comprehensive neurological examination. Detecting Hydrocephalus promptly is essential for determining the appropriate course of action.

In cases of increased brain pressure at birth, neurosurgery may be necessary. At NJ Pediatric Neurosciense institute, two surgical options are available: a fetal shunt, which helps normalize brain pressure by draining fluid into the abdominal cavity for reabsorption, and an Endoscopic third ventriculostomy (ETV), a minimally-invasive procedure that creates an opening in the brain's third ventricle to allow fluid to flow normally.

The impact of pediatric Hydrocephalus on a baby can vary in severity and is not always predictable. This condition can lead to complications and symptoms of brain damage, such as epilepsy, learning disabilities, memory loss, coordination issues, vision problems, and early puberty. Early intervention, including developmental therapy like physical and occupational therapy, is crucial for babies with Hydrocephalus. With timely treatment, some babies may develop normally despite the condition.

Overall, Hydrocephalus requires careful management and monitoring to support the baby's development and well-being.

How to Prevent Hydrocephalus in Pregnancy

While there's currently no way to prevent hydrocephalus in your child, there are still steps you can take for future pregnancies.  Your doctor might recommend genetic counseling to assess the risk of hydrocephalus reappearing. This counseling can provide valuable information and peace of mind as you plan your family. Additionally, depending on the cause of your child's hydrocephalus, prenatal testing may be an option in future pregnancies to identify hydrocephalus early on.