**4. Results**

with a high risk of premature death, stillbirth, or neonatal death, are often referred to as "lethal," as it is assumed that their potential treatment will be unsuccessful, which is the basis for the decision for the interruption of pregnancy due to medical reasons [1, 2]. Depending on the clinical criteria used in the definition of the disease, its incidence varies from 1 to 32 per 10,000 live births [3]. An increase in the prenatal diagnosis of CH has been observed, whereas the incidence of stillbirths remains stable. The interruption of pregnancy due to medical reasons reduces by almost a half the rate of hydrocephalus in live births. Currently, prenatal ultrasound is able to visualize ventriculomegaly, which can be caused by a number of reasons. Knowledge of the risk factors associated with CH may increase the chances of an early prenatal ultrasound diagnosis. Animal experiments have found that a wide range of environmental factors can cause hydrocephalus. They include alcohol consumption, X-rays, infections, eating disorders, and exposure to chemicals during pregnancy [4]. It has been established that one gene (L1 of Xq28 encoded for L1CAM) is connected with CH in humans. Although X-linked CH has a frequency of about 2–7% of all cases, L1CAM is found in about 15% of sporadic cases [5]. L1CAM mutations are closely related to stenosis of the cerebral aqueduct, the major pathology causing hydrocephalus in these cases. Sipek et al., in their study of CH for the period 1961–2000 in the Czech Republic, found that a mother's age of over 37 years was statistically significantly related to CH, unlike the study by Van

To study the prenatally ultrasound diagnosed ventriculomegaly by fetopathological autopsy in fetuses, which ended in interruption of pregnancy due to medical reasons, stillbirth, or neonatal death, by searching associated with the congenital hydrocephalus isolated or syndromic

A total of 113 fetuses with CH were studied whose outcome was lethal. One hundred and three of them were received over a period of 3 years (2006–2009) and autopsied at the Embryo-Fetopathologic Clinic at the Center for Maternity and Neonatology, Tunis, Tunisia, out of a total of 21,316 births. Ten of the cases were from the Obstetrics and Gynecology Clinic at St. George EAD University Hospital, Plovdiv, Bulgaria, during the year 2016 out of a total of 2104 deliveries. The incidence of fetal hydrocephalus with a lethal outcome (FHLO) in both centers

The fetuses are the result of interruption of pregnancy due to medical reasons, spontaneous abortions, and stillbirths. The maternal and fetal data were collected from the obstetric history, and a classical autopsy was performed immediately following the expulsion of

malformations as well as the eventual risk factors for their occurrence.

Landingham et al. [4, 6].

72 Congenital Anomalies - From the Embryo to the Neonate

**2. Aim of the study**

**3. Materials and methods**

is almost identical—4.8 and 4.9 per 1000 births.

