Intrapartum Management of the Fetus with Idiopathic Hydrocephalus

Intrapartum management of fetal idiopathic hydrocephalus (IH) diagnosed late in pregnancy is controversial. Normal intellectual development is possible in many of these infants when neurosurgical intervention is undertaken in the neonatal period. Aggressive intrapartum management is indicated in most of these cases regardless of cortical mantle thickness. However, routine abdominal delivery is associated with increased maternal morbidity without proven fetal benefit. Transvaginal cephalocentesis for fetuses with IH in the cephalic presentation, followed by spontaneous vaginal delivery, lessens maternal morbidity and is compatible with good neonatal outcome.