Management of Choroid Plexus Cysts in the Mid-Trimester Fetus

Fetal choroid plexus cysts: are we there yet?

“…It is well established that the risk of trisomy 18 increases with age (Snidjers et al, 1995). Thus likelihood ratios of 3.5±4 (Snidjers et al, 1994a), or 9 (Gupta et al, 1997;Choong and Meagher, 1999) are found. However, the`adjustment' factor is dependent on calculations similar to those given above, and is dependent on interpretation of the literature.…”

“…Differing formulae have been used to modify age speci®c risk by a risk factor, usually a likelihood ratio, imparted by the ®nding of isolated choroid plexus cysts (Snidjers et al, 1994a;Gratton et al, 1996;Gupta et al, 1997;Choong and Meagher, 1999). Age cut-off values of 37 years (Choong and Meagher, 1999), 33 years (Gratton et al, 1996), 28 years (Gupta et al, 1995) and 36 years (Chitty et al, 1998) have been suggested.. Few reviews have pre-speci®ed inclusion criteria and often consist of a simple synthesis of published reports. Thus likelihood ratios of 3.5±4 (Snidjers et al, 1994a), or 9 (Gupta et al, 1997;Choong and Meagher, 1999) are found.…”

Isolated ‘soft signs’ of fetal choroid plexus cysts or echogenic intracardiac focus – consequences of their continued reporting

“…1,19,20 Consequent invasive testing with the potential of harm, anxiety, conflict of personal values and clinical ambiguity is at odds with the premise of prenatal screening, to prevent suffering. 4 Of the 102 low-risk women with an isolated soft sign in this study, a substantial proportion underwent both genetic counselling and MFM scan, amniocentesis, NIPT and/or additional follow-up ultrasounds. Additionally, the public health impact of unnecessary genetic counselling, maternal-fetal medicine services and invasive testing must be considered.…”

“…1 EIF is microcalcifications of the papillary muscle or chordae tendineae (Figure 1). 4,5 Although found in 0.3-3.5% of the general population, CPC, as shown in Figure 2, are considered to be markers of trisomy 18 due to a reported prevalence of 30-50% in affected fetuses. 2,3 Similarly, CPC, which are formed when neuroepithelial folds fill with CSF and cellular debris, are of no pathological significance.…”

Choroid Plexus Cysts

“…Likelihood ratios of 3 to 9 have been found with an age cutoff from 33 to 37. 6,36,37,40,41 The results from these studies are principally based on reviews with nonspecific inclusion criteria, and the risk adjustment is dependent on interpretation of the literature. In our case, the patient's risk would have been low because of young maternal age.…”