A 32-year-old gravida 1, para 0 woman was referred to our maternal fetal care center at 35 weeks’ gestation for a new finding of bilateral ventriculomegaly. The pregnancy had been uncomplicated and prenatal laboratory testing was unremarkable. Maternal medications included prenatal vitamins, with loratadine, acetaminophen, and lorazepam as needed. Maternal and family history did not include any severe neonatal or childhood conditions. Cell-free fetal DNA screening did not detect aneuploidy. Findings of fetal anatomic survey were normal at 20 weeks’ gestation, and follow-up ultrasonography to assess cord insertion showed only marginal cord insertion diagnosed at 32 weeks’ gestation. Fetal ultrasonography performed at 35 weeks’ gestation for evaluation of fetal growth demonstrated a new finding of bilateral ventriculomegaly with dilation of the third ventricle, concerning for aqueductal stenosis (Fig 1A).

A multidisciplinary team reviewed the prenatal records and performed both fetal ultrasonography and magnetic resonance imaging (MRI) at 36...

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