**7. System anomalies of the fetus**

The head, extremities, and respiratory system anomalies associated with FHLO are presented in **Table 1**.

The cardiovascular system abnormalities are a total of 32 and are from all groups. The digestive system abnormalities are 56 and are broken down into groups: mesenteric (affecting the small intestine and colon), parenchymal (affecting the liver and spleen), anal imperforation (affecting the terminal part of the intestines), gall bladder agenesis, and situs inversus. The parenchymal and mesenteric abnormalities are evenly distributed. The gender abnormalities are present in both male and female fetuses with a ratio of female to male of 8:7. Hermaphroditism was established in four (3.5%) fetuses. The fatal hydrocephalus-associated anomalies of the cardiovascular, digestive, excretory, and genital systems are presented in **Table 2**.

**Association of hydrocephalus with other brain abnormalities.** In 85 fetuses (76%), hydrocephalus was associated with other brain abnormalities: polygyria—12 (10.7%); lissencephaly—2 (1.8%); agenesis of corpus callosum—18 (16%); agenesis of the cerebellar vermis—19 (16.9%); diastamatomyelia—1 (0.9%); stenosis of the Sylvian aqueduct—5 (4.4%); holoprosencephaly—1 (0.9%) and cyst of the choroid plexus—2 (1.8%) (**Table 3**, **Figure 4**). The relations between the prenatal and postnatal diagnosis of hydrocephalus-associated brain abnormalities are shown in **Figure 3**.

Most are neural tube defects followed by trisomies and skeletal dysplasias. The VACTERL association has been established in six fetuses (5.3%), four of which were male and two female,

The Meckel-Gruber syndrome, which is a ciliopathy, was established six times (5.4%). A karyotype study was performed on 23 fetuses (20.5%)—one by fluorescent in situ hybridization (FISH) and the rest by chromosome study. A magnetic resonance tomography (MRI) was

**Systems Types of anomalies Anomalies** *N***/%**

Dextroradia Cardiomegaly

Correlations between Ultrasound and Pathology in Fetal Ventricular System Anomalies

http://dx.doi.org/10.5772/intechopen.71934

Both together Tetralogy of Fallot

Ventricular septal defect (VSD)

AV channel of the heart

Pulmonary valve stenosis

Minor form of AV channel of the heart

Defects Atrial septal defect (ASD)

Stenoses Aortic valve stenosis

Parenchymal Hepatomegaly

Transposition Transposition of the great vessels (TGV)

Isomerism Isomerism of incoming vessels of the heart

Hypoplasia Hypoplastic right heart syndrome (HRHS)

Total 32/28.3

Hemi-mesenter

Splenomegaly

Polysplenia Accessory spleen

Imperforations Imperforate anus 8/7.1 Agenesis Gallbladder Agenesis 1/0.9 Situs inversus 1/0.9 Total 56/49.5

Hepato-splenomegaly

1/0.9 2/1.8 77

3/2.7 11/9.7 2/1.8 2/1.8 2/18 2/1.8

1/0.9 1/0.9

1/0.9

3/2.7

1/0.9

1/0.9 22/19.5

8/7.1 3/2.7 5/4.4 6/5.3 1/0.9

and the Dandy-Walker malformation in four fetuses (3.5%) (**Figure 4**).

Position Organomegaly

Digestive system abnormalities Mesenterial Common mesentery

performed in three cases.

Anomalies of the cardiovascular

system

The hydrocephalus-associated syndromes and malformations are presented in **Table 4**.


**Table 1.** Hydrocephalus-related abnormalities of the head, extremities, and respiratory system.

Most are neural tube defects followed by trisomies and skeletal dysplasias. The VACTERL association has been established in six fetuses (5.3%), four of which were male and two female, and the Dandy-Walker malformation in four fetuses (3.5%) (**Figure 4**).

**Association of hydrocephalus with other brain abnormalities.** In 85 fetuses (76%), hydrocephalus was associated with other brain abnormalities: polygyria—12 (10.7%); lissencephaly—2 (1.8%); agenesis of corpus callosum—18 (16%); agenesis of the cerebellar vermis—19 (16.9%); diastamatomyelia—1 (0.9%); stenosis of the Sylvian aqueduct—5 (4.4%); holoprosencephaly—1 (0.9%) and cyst of the choroid plexus—2 (1.8%) (**Table 3**, **Figure 4**). The relations between the prenatal and postnatal diagnosis of hydrocephalus-associated brain abnormali-

The hydrocephalus-associated syndromes and malformations are presented in **Table 4**.

**Systems Types of anomalies Anomalies** *N***/%**

Agenesia Atresia Total

Limb Agenesia Clinodactyly Polydactyly Syndactyly Total

Incorrect lobulation Hypoplasia and Incorrect lobulation Situs inversus Liver agenesis

Total

**Table 1.** Hydrocephalus-related abnormalities of the head, extremities, and respiratory system.

Cleft palate Labia palate cleft Uvula cleft palate

Configurations High palate 25/22.1 Total 39/34.5

> Snub nose Arrhinia Choanal atresia

Macrocrania Curved foot Short limbs Agenesia of finger Finger clinodactyly 6/5.3 3/2.7 4/3.5 1/0.9

4/3.5 1/0.9 1/0.9 6/5.3

70/61.9 23/20.4 13/11.5 6/5.3 28/24.7 6/5.3 9/7.9 182/161

21/18.6 16/14.2 6/5.3

2/1.8 1/0.9 46/40.7

Lips, soft and hard palate Clefts Cleft lip

Anomalies of the nose Configurations

Head and limb abnormalities Head

Anomalies of the respiratory system Hypoplasia

ties are shown in **Figure 3**.

76 Congenital Anomalies - From the Embryo to the Neonate

The Meckel-Gruber syndrome, which is a ciliopathy, was established six times (5.4%). A karyotype study was performed on 23 fetuses (20.5%)—one by fluorescent in situ hybridization (FISH) and the rest by chromosome study. A magnetic resonance tomography (MRI) was performed in three cases.



**Table 2.** Hydrocephalus-related abnormalities of cardiovascular, digestive, excretory, and genital systems.

The degree of hydrocephalus according to the fetopathological study is major hydrocephalus (hydrancephaly; >15 mm)—15 cases (13.3%) and ventriculomegaly (>10 mm)—77 cases (69%). Obstructive hydrocephalus as a result of intraventricular hemorrhage was found in 20 fetuses (17.7%) (**Table 5**, **Figure 4**).

The assessment of the significance of spontaneous abortions, abortions due to medical reasons, stillbirth, and a previous child with malformations as risk factors for the occurrence of hydrocephalus was accomplished by means of a χ<sup>2</sup> -analysis (**Table 6**).

of a pre-term birth of a child with a malformation, compared to the studied risk factors. The assessment of the significance of the different degrees of consanguinity in the presence of a child with malformations, epileptic mother, as well as the mother's age is shown in **Table 7**. The incidence of FHLO is nearly six times higher when it is the result of a consanguineous marriage with a history of a previous pregnancy with a malformation, relative to the presence of hydrocephalus of a non-consanguineous marriage with no such a history. Almost 13 times higher is the incidence of FHLO in cases of maternal epilepsy with a consanguineous marriage of first degree (first cousins), when compared to the proportion of FHLO in a fetus

**Figure 3.** Relations between the prenatal and postnatal diagnosis of hydrocephalus-associated brain abnormalities.

**Brain associations Number of cases %** Polygyria 12 10.6 Lissencephaly 2 1.8 Agenesis of corpus callosum 18 15.9 Agenesis of cerebellar vermis 19 16.8 Cerebellar hypoplasia 25 22.1 Diastematomyelia 1 0.9 Aqueductal stenosis (stenosis of the aqueduct of Sylvius) 5 4.4 Holoprosencephaly 1 0.9 Choroid plexus cysts 2 1.8 Total 85 75.2

Correlations between Ultrasound and Pathology in Fetal Ventricular System Anomalies

http://dx.doi.org/10.5772/intechopen.71934

79

**Table 3.** Distribution of associated brain abnormalities with lethal hydrocephalus.

Abbreviations: CC, corpus callosum; CV, cerebeller vermis; H, hypoplasia.

The proportion of spontaneous abortion is almost four times higher, and the abortion due to medical reasons is more than four times higher, when compared to other risk factors for FHLO. Hydrocephalus is almost three times more likely to develop in cases of previous stillbirths in the obstetric history and more than two times more likely to occur in the presence


**Table 3.** Distribution of associated brain abnormalities with lethal hydrocephalus.

The degree of hydrocephalus according to the fetopathological study is major hydrocephalus (hydrancephaly; >15 mm)—15 cases (13.3%) and ventriculomegaly (>10 mm)—77 cases (69%). Obstructive hydrocephalus as a result of intraventricular hemorrhage was found in 20 fetuses

**Table 2.** Hydrocephalus-related abnormalities of cardiovascular, digestive, excretory, and genital systems.

Male Hypospadias

**Systems Types of anomalies Anomalies** *N***/%**

Kidneys Ptosis of the kidney

Urinary tract Pelvicalyceal dilatation

Horseshoe kidney

Hydrophoresis Tubular necrosis Dysplasia Cystic dysplasia

Megaureter Mega-bladder

Hypoplasia of bladder Colovesical fistula Agenesis of ureter

Total 53/46.9

Posterior urethral valve

Hydrocolpos

Cryptorchism

Hermaphroditism 4/3.4 Total 19/16.8

Ovarian hypoplasia Vaginal Atresia

Agenesis (uni- and bilateral)

10/8.8 4/3.4 8/7.1 5/4.4 1/0.9 2/1.9 6/5.3

4/3.4 2/1.8 2/1.8 3/2.7 1/0.9 5/4.4

5/4.4 1/0.9 1/0.9 2/1.8

4/3.4 1/0.9 2/1.8

The assessment of the significance of spontaneous abortions, abortions due to medical reasons, stillbirth, and a previous child with malformations as risk factors for the occurrence of

The proportion of spontaneous abortion is almost four times higher, and the abortion due to medical reasons is more than four times higher, when compared to other risk factors for FHLO. Hydrocephalus is almost three times more likely to develop in cases of previous stillbirths in the obstetric history and more than two times more likely to occur in the presence


(17.7%) (**Table 5**, **Figure 4**).

Anomalies of kidney and urinary

78 Congenital Anomalies - From the Embryo to the Neonate

tract

hydrocephalus was accomplished by means of a χ<sup>2</sup>

Anomalies of the genitals Female Bicornuate uterus

**Figure 3.** Relations between the prenatal and postnatal diagnosis of hydrocephalus-associated brain abnormalities. Abbreviations: CC, corpus callosum; CV, cerebeller vermis; H, hypoplasia.

of a pre-term birth of a child with a malformation, compared to the studied risk factors. The assessment of the significance of the different degrees of consanguinity in the presence of a child with malformations, epileptic mother, as well as the mother's age is shown in **Table 7**.

The incidence of FHLO is nearly six times higher when it is the result of a consanguineous marriage with a history of a previous pregnancy with a malformation, relative to the presence of hydrocephalus of a non-consanguineous marriage with no such a history. Almost 13 times higher is the incidence of FHLO in cases of maternal epilepsy with a consanguineous marriage of first degree (first cousins), when compared to the proportion of FHLO in a fetus

**Figure 4.** (A) Polygria (inferior view of the brain); (B) Agenesis of corpus callosum (medical view of hemisphere); (C) Extracted brain and spinal cord from the skull and vertebral canal. Split of the cord. Diastematomyelia; (D) Thoraclumbar spina bifidia; (E) Occipital meningo-encephalocele; (F) Rachischisis; (G) Wedging of the cerebellar tonsils through the foramen magnum. Arnold-Chiari malformation; (H) Cystic dilatation of IVth ventricle, elevating of the tentorium, cerebellar hypoplasia. Dandy-Walker malformation; (I) Ventriculomegaly-ultrasound examination; (J) Ventriculomegaly (horizontal section of the right hemisphere); (K) Holoprosencephaly. Fetal MRI; (L) Holoprosencephaly. Fetal autopsy (White-black arrow—hemisphere, white arrow—brain stem, dotted arrow—cerebellum).

carried by an epileptic mother but not from such a marriage. Over four times higher is the proportion of FHLO in cases of consanguinity of second degree, when compared to hydrocephalus influenced by the other studied maternal risk factors. Almost four times higher is the proportion of FHLO with a maternal age between 27 and 35 years compared to other ages, with maternal risk factors present. The rate of hydrocephalus when the maternal age is over 40 years and with consanguinity of third degree is 13 times greater than women over 40 years of age without the risk factor consanguinity. The assessment of the degree of risk of consanguinity, the presence of spontaneous abortion, and the mother's blood group is presented in **Table 8**.

When the mother is from the A(+) blood group and has a consanguineous marriage (giving second-degree consanguinity in the fetus), FHLO has a two times higher incidence than in cases without consanguinity. Around two times higher is the incidence of FHLO, carried by mothers with O(+) blood group and a history of a previous spontaneous abortion,

compared to the occurrence when there is no such history. The degree of significance of the mother's age for the incidence of polygyria and abortions, obstetric and other risk factors, as well as the blood group for the occurrence of agenesis of the cerebellar vermis are shown

Total

**Types of anomalies Anomalies** *N***/%**

Myelomeningocelе Encephalocele Meningocele Rachischisis Total

Correlations between Ultrasound and Pathology in Fetal Ventricular System Anomalies

Trisomy 18 Trisomy 13 Trisomy 15 Trisomy 7 + 2 Triplodia Total

Thanatophoric dysplasia Osteochondrodysplasia Osteogenesis imperfecta

Arthrogryposis

Total

Isomerism

Fraser syndrome Fryns syndrome

Meckel-Gruber syndrome

Arnold-Chiari malformation

VACTERL association 6/5.3 Dandy-Walker malformation 4/3.4

10/8.8 6/5.3 6/5.3 6/5.3 5/4.4 33/29.2 81

http://dx.doi.org/10.5772/intechopen.71934

4/3.4 18/15.9 2/1.8 1/0.9 1/0.9 1/0.9 27/23.9

1/0.9 3/2.7 1/0.9 2/1.8 3/2.7 10/9.8

1/0.9 3/2.7 6/5.3 1/0.9 1/0.9 4/3.4 16/14.2

Neural tube defects Spina bifida

Chromosomal abnormalities Trisomy 21

Skeletal dysplasias Ellis-van Creveld syndrome

Other syndromes and malformation DiGeorge syndrome

**Table 4.** Distribution of syndromes and malformations associated with lethal hydrocephalus.

in **Table 9**.

Correlations between Ultrasound and Pathology in Fetal Ventricular System Anomalies http://dx.doi.org/10.5772/intechopen.71934 81


**Table 4.** Distribution of syndromes and malformations associated with lethal hydrocephalus.

carried by an epileptic mother but not from such a marriage. Over four times higher is the proportion of FHLO in cases of consanguinity of second degree, when compared to hydrocephalus influenced by the other studied maternal risk factors. Almost four times higher is the proportion of FHLO with a maternal age between 27 and 35 years compared to other ages, with maternal risk factors present. The rate of hydrocephalus when the maternal age is over 40 years and with consanguinity of third degree is 13 times greater than women over 40 years of age without the risk factor consanguinity. The assessment of the degree of risk of consanguinity, the presence of spontaneous abortion, and the mother's blood group is presented in

(White-black arrow—hemisphere, white arrow—brain stem, dotted arrow—cerebellum).

80 Congenital Anomalies - From the Embryo to the Neonate

**Figure 4.** (A) Polygria (inferior view of the brain); (B) Agenesis of corpus callosum (medical view of hemisphere); (C) Extracted brain and spinal cord from the skull and vertebral canal. Split of the cord. Diastematomyelia; (D) Thoraclumbar spina bifidia; (E) Occipital meningo-encephalocele; (F) Rachischisis; (G) Wedging of the cerebellar tonsils through the foramen magnum. Arnold-Chiari malformation; (H) Cystic dilatation of IVth ventricle, elevating of the tentorium, cerebellar hypoplasia. Dandy-Walker malformation; (I) Ventriculomegaly-ultrasound examination; (J) Ventriculomegaly (horizontal section of the right hemisphere); (K) Holoprosencephaly. Fetal MRI; (L) Holoprosencephaly. Fetal autopsy

When the mother is from the A(+) blood group and has a consanguineous marriage (giving second-degree consanguinity in the fetus), FHLO has a two times higher incidence than in cases without consanguinity. Around two times higher is the incidence of FHLO, carried by mothers with O(+) blood group and a history of a previous spontaneous abortion,

**Table 8**.

compared to the occurrence when there is no such history. The degree of significance of the mother's age for the incidence of polygyria and abortions, obstetric and other risk factors, as well as the blood group for the occurrence of agenesis of the cerebellar vermis are shown in **Table 9**.


**Table 5.** Distribution of data on the extent and origin of hydrocephalus.


**Table 6.** Risk factors and lethal hydrocephalus.

The association of FHLO and polygyria is more than three times higher in cases where the mother is over 35 years of age, when compared to cases with a mother's age less than 35 years. More than 2.5 times higher is the incidence of FHLO associated with agenesis of the cerebellar vermis in cases of a mother with a previous abortion, when compared to cases without a previous abortion. In the present study, the incidence of the association FHLO and agenesis of the cerebellar vermis is more than two times higher when exposed to the obstetric risk factors. Almost three times higher is the incidence of the association of FHLO and agenesis of the cerebellum in cases in which the mother's blood group is A(+), when compared to other maternal blood groups. The assessment of the importance of the

maternal age for the association of hydrocephalus with trisomies, as well as the mother's blood group for the association of hydrocephalus and agenesis of corpus callosum is pre-

The rate of FTLO associated with trisomy is more than six times higher when the mother's age is over 38 years of age, than in younger than 38-year-old mothers. Almost three times higher is the share of the association of FHLO with agenesis of corpus callosum in the fetus in cases

sented in **Table 10**.

Consanguinity first degree

Consanguinity second degree

Consanguinity third degree

**Indicators Groups Without risk** 

35 years

**Indicators Groups Under 40 years** 

**factors**

**of age**

Abbreviations: No, number; CI, confidence intervals; OR, odds ratio; *χ*<sup>2</sup>

**Table 7.** Consanguinity, risk factors, and lethal hydrocephalus.

of O(+) maternal blood group.

**Indicators Groups No malformation Baby with** 

**malformation**

There are 27 77.1 8 22.9 35 100.0 (1.806–29.584)

*N* **%** *N* **%** *N* **% (CI)**

There are 7 50.0 7 50.0 14 100.0 (5.189–117.247)

**Risk factors Total** *χ***<sup>2</sup>** *Р* **OR**

**Over 40 years Total** *χ***<sup>2</sup>** *Р* **OR**

, chi-square; *P*, sig.

No 77 96.1 3 3.9 77 100.0 25.742 0.000 24.667

No 71 93.4 5 6.6 76 100.0 4.014 0.045 75.680 (0.872–36.997) There are <sup>5</sup> 71.4 <sup>2</sup> 28.6 <sup>7</sup> 100.0

No 74 97.4 2 2.6 76 100.0 7.447 0.006 18.500

There are 2 66.7 1 33.3 3 100.0 (1.146–298.547)

(0.977–18.601) 27–

*N* **%** *N* **%** *N* **%** Consanguinity No 74 96.1 3 3.9 77 100.0 9.768 0.002 7.309

**Indicators Groups Without epilepsy Epilepsy Total** *χ***<sup>2</sup>** *Р* **OR**

*N* **%** *N* **%** *N* **%**

Maternal age Others 81 95.3 4 4.7 85 100.0 4.247 0.039 4.203

*N* **%** *N* **%** *N* **%**

19 82.6 4 17.4 23 100.0

Total 101 90.2 11 9.8 112 100.0

Total 84 89.0 10 11.0 94 100.0

Total 76 91.6 7 8.4 83 100.0

Total 100 92.6 8 7.4 108 100.0

Total 76 96.2 3 3.8 79 100.0

**Total** *χ***<sup>2</sup> Fisher**

Correlations between Ultrasound and Pathology in Fetal Ventricular System Anomalies

*Р*

http://dx.doi.org/10.5772/intechopen.71934

**OR (CI)** 83

**(CI)**

**(CI)**


Abbreviations: No, number; CI, confidence intervals; OR, odds ratio; *χ*<sup>2</sup> , chi-square; *P*, sig.

**Table 7.** Consanguinity, risk factors, and lethal hydrocephalus.

The association of FHLO and polygyria is more than three times higher in cases where the mother is over 35 years of age, when compared to cases with a mother's age less than 35 years. More than 2.5 times higher is the incidence of FHLO associated with agenesis of the cerebellar vermis in cases of a mother with a previous abortion, when compared to cases without a previous abortion. In the present study, the incidence of the association FHLO and agenesis of the cerebellar vermis is more than two times higher when exposed to the obstetric risk factors. Almost three times higher is the incidence of the association of FHLO and agenesis of the cerebellum in cases in which the mother's blood group is A(+), when compared to other maternal blood groups. The assessment of the importance of the

**According to the degree of hydrocephalus Number of cases %** Major hydrocephalus (hydranencephaly) 15 13.3% Ventriculomegaly 78 69.0% Hydrocephaly due to intraventricular hemorrhage 20 17.7% Total 113 100.0%

*N* **%** *N* **%** *N* **%** Miscarriage No 78 78 22 22 100 100.0 21.816 0.000 19.500

Abortion No 78 81.3 18 18.8 96 100.0 33.727 0.000 32.500

Stillbirth No 79 73.1 29 29.6 108 100.0 6.529 0.011 10.897

Total 80 70.8 33 29.2 11 100.0

Total 80 70.8 33 29.2 113 100.0

total 80 70.8 33 29.2 113 100.0

Total 80 70.8 33 29.2 113 100.0

Abbreviations: No, number; CI, confidence intervals; OR, odds ratio; *χ*<sup>2</sup>

**Table 6.** Risk factors and lethal hydrocephalus.

**Risk factors Total** *χ***<sup>2</sup> Fisher**

There are 2 15.4 11 84.6 13 100.0 (4.020–94.594)

There are 2 11.8 15 88.2 17 100.0 (6.817–154.954)

There are 1 20 4 80 5 100.0 (1.169–10.564)

There are 4 36.4 7 63.6 11 100.0 (1.385–18.896)

, chi-square; *P*, sig.

No 76 75.4 26 25.5 102 100.0 6.988 0.008 5.385

*Р*

**OR (CI)**

**Table 5.** Distribution of data on the extent and origin of hydrocephalus.

**factors**

**Indicators Groups Without risk** 

82 Congenital Anomalies - From the Embryo to the Neonate

Baby with malformation

> maternal age for the association of hydrocephalus with trisomies, as well as the mother's blood group for the association of hydrocephalus and agenesis of corpus callosum is presented in **Table 10**.

> The rate of FTLO associated with trisomy is more than six times higher when the mother's age is over 38 years of age, than in younger than 38-year-old mothers. Almost three times higher is the share of the association of FHLO with agenesis of corpus callosum in the fetus in cases of O(+) maternal blood group.


Abbreviations: No, number; CI, confidence intervals; OR, odds ratio; *χ*<sup>2</sup> , chi-square; *P*, sig.

**Table 8.** Blood groups, risk factors, and lethal hydrocephalus.


**8. Discussion**

O+ blood group

Currently, prenatal ultrasound is able to visualize ventriculomegaly. Knowledge of the risk factors associated with CH may increase the success of the prenatal ultrasound study. It has been established that a wide range of factors can cause hydrocephalus in animal experiments including alcohol consumption [7], X-ray [8], infections, food disorders, exposure to chemi-

**Indicators Groups Without trisomy Trisomy Total** *χ***<sup>2</sup>** *Р* **OR**

Maternal age ≤38 88 90.7 9 9.3 97 100.0 20.518 0.000 13.689

*N* **%** *N* **%** *N* **%**

**Agenesis of corpus callosum**

No 53 86.9 8 13.1 61 100.0 4.441 0.035 3.614

≥38 5 41.7 7 58.3 12 100.0 total 93 85.3 16 14.7 109 100.0

There are 11 64.7 6 35.3 17 100.0 Total 64 82.1 14 17.9 78 100.0

*N* **%** *N* **%** *N* **% (CI)**

Correlations between Ultrasound and Pathology in Fetal Ventricular System Anomalies

**Total** *χ***<sup>2</sup>** *Р* **OR**

http://dx.doi.org/10.5772/intechopen.71934

, chi-square; *P*, sig.

(3.952– 52.122) 85

**(CI)**

(1.044– 12.510)

Our study is similar to those of Fernell et al., Stoll et al., and Porto et al. which showed that CH was significantly associated with previous abortions, stillbirth, and birth of a child with a malformation [11–13]. Our findings show that the risk of FHLO is increased in cases of previous spontaneous abortions (odds ratio (OR) = 19.500, confidence interval (CI): 4.020–94.594), stillbirth (OR = 10.897; CI: 1.169–10.564), and births of a child with a malformation (OR=5.385; CI: 1.385–18.896). Pregnancy complications, such as an increase in the amniotic fluid over 1500 ml (polyhydramnios) or a reduction below 500 ml (oligohydramnios), are also considered as potential risk factors for CH [12, 13]. The role of consanguinity is also known for the occurrence of congenital malformations such as hydrocephalus, postaxial polydactyly of the hands, and defects of the lips and palate [13, 14]. In our study, FHLO is significantly associated with a maternal age over 40 years and third-degree consanguinity of the fetus (OR = 18.500; CI: 1.146–298.547). FHLO, previous pregnancies with malformations, and consanguinity are also significantly associated (OR = 7.309; CI: 1.806–29.584). FHLO with agenesis of the cerebellar vermis is significantly associated with the effect of obstetric

Almost all studies have documented a slightly higher percentage of male fetuses in cases of CH in live births and stillbirths as well as in fetopathologic autopsies [15–18]. Van Landingham et al. did not find a difference in the genders of the children with hydrocephalus compared to

cals [9] and medications taken during pregnancy [10].

**Indicators Groups Without agenesis of** 

**corpus callosum**

Abbreviations: No, number; CI, confidence intervals; OR, odds ratio; *χ*<sup>2</sup>

**Table 10.** Risk factors, trisomy, agenesis of corpus callosum, and lethal hydrocephalus.

risk factors (OR = 2.905; CI: 1.048–8.052).

the general population [4].


Abbreviations: No, number; CI, confidence intervals; OR, odds ratio; *χ*<sup>2</sup> , chi-square; *P*, sig.

**Table 9.** Brain abnormalities, risk factors, and lethal hydrocephalus.


**Table 10.** Risk factors, trisomy, agenesis of corpus callosum, and lethal hydrocephalus.
