ABSTRACT
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.
