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Poster Session 1

Category: Medical/Surgical/Diseases/Complications

Poster Session 1

(236) Maternal and perinatal course in antenatally diagnosed Vein of Galen malformation (VOGM)

Wednesday, February 11, 2026

10:30 AM - 12:00 PM

Submitting Author and Presenting Author(s)

Jennifer M. Watchmaker, MD, PhD

Neuroendovascular Surgery Fellow
Icahn School of Medicine at Mount Sinai
Icahn School of Medicine at Mount Sinai, New York, United States

Coauthor(s)

BP

Brandon Philbrick, MD

Icahn School of Medicine at Mount Sinai
Icahn School of Medicine at Mount Sinai, New York, United States
AD

Alex Devarajan, BA

Icahn School of Medicine at Mount Sinai
Icahn School of Medicine at Mount Sinai, New York, United States
AB

Alejandro Berenstein, MD

Icahn School of Medicine at Mount Sinai
Icahn School of Medicine at Mount Sinai, New York, United States
MG

Miwa Geiger, MD

Icahn School of Medicine at Mount Sinai Hospital
New York, New York, United States
AB

Angela T. Bianco, MD

Professor and Division Director, Maternal-Fetal Medicine
Icahn School of Medicine at Mount Sinai
New York, New York, United States
TS

Tomoyoshi Shigematsu, MD, PhD

Icahn School of Medicine at Mount Sinai
Icahn School of Medicine at Mount Sinai, New York, United States
JF

Johanna Fifi, MD

Icahn School of Medicine at Mount Sinai
Icahn School of Medicine at Mount Sinai, New York, United States

Objective:
VOGM is increasingly diagnosed in utero, allowing for prenatal counseling and delivery planning. However, data on the timing and nature of perinatal care is limited. This study aims to describe the perinatal care timeline and outcomes for pregnancies affected by VOGM, with the goal of informing multidisciplinary care pathways.

Study Design:
We conducted a retrospective review of all pregnancies with antenatal VOGM diagnosis born at our referral center between 2014 and 2025. Data collected included maternal demographics, gestational age (GA) at diagnosis, GA at fetal MRI and neurointerventional consultation, antenatal digoxin use, GA at delivery, mode of delivery, and neonatal outcomes.

Results:
Of 33 reviewed neonatal VOGM cases, 25 pregnancies with an antenatal diagnosis of VOGM were included in the analysis. The median maternal age was 32.9 years, and VOGM was detected at a median GA of 32.1 weeks. Fetal MRI was performed in 22 cases, and consultation with neurointerventional surgery was performed at a median GA of 33.3 weeks. Antenatal digoxin was initiated in 22.7% of cases for management of high-output cardiac failure detected on fetal echocardiogram. Cesarean delivery was the predominant mode of delivery (83.3%), with median GA at delivery of 37.6 weeks and median birthweight of 3.3 kg. Among neonates, 64% underwent endovascular embolization during the birth hospitalization (median age at first embolization was 1.4 days). There were 3 neonatal mortalities, one in which embolization was not offered due to extensive brain injury on postnatal MRI, and two mortalities following embolization. The median length of birth admission was 16.5 days for survivors (7.0 days for patients not requiring neonatal embolization, and 28 days for patients who underwent neonatal embolization).

Conclusion:
In cases requiring neonatal intervention, embolization was frequently performed shortly after birth. Given the complexity of VOGM, timely coordination with specialized centers with neurointerventional and neonatal expertise following antenatal diagnosis may be critical to optimizing outcomes.