Perinatal outcomes of choroid plexus cysts in a high-risk pregnant population: A tertiary center experience

Year 2024, Volume: 3 Issue: 2, 77 - 81, 28.06.2024

Murat Haksever , Atakan Tanacan , Esra Karataş , Osman Onur Özkavak , Refaettin Şahin , Hakkı Şerbetçi , Ezgi Başaran , Ekin Ersoy , Dilek Sahin

Abstract

Introductıon: The objective of this study was to present the results of fetuses followed up for choroid plexus cysts(CPC) in our clinic and to provide an additional benefit to the existing literature.
Methods: This is a retrospective cohort study conducted in Ankara Bilkent City Hospital perinatology clinic. All pregnant women who were followed up with a antenatally diagnosed choroid plexus cyst between 2021 and 2023 were included in the study. Demographic characteristics, prenatal ultrasound findings, non-invasive screening test results, invasive diagnostic test results, clinical management and postnatal outcomes were evaluated and compared between unilateral CPC group and bilateral CPC group.
Results: A comparison between unilateral and bilateral groups revealed no significant differences in maternal age, gravidity, parity, or number of abortions. However, the week of diagnosis was found to be smaller in the group with bilateral choroid plexus cysts (p=0.004). Patients undergoing invasive testing were higher in the bilateral CPC group, although these differences were not statistically significant. There was no statistically significant difference between the groups in terms of pregnancy termination rate, gestational week at delivery, neonatal weight, NICU admission, and APGAR scores. The group with additional anomalies exhibited a higher rate of high-risk screening tests, a higher rate of anomaly detection in invasive tests, and a higher rate of pregnancy termination. Nevertheless, these differences were not statistically significant
Conclusion: In conclusion, fetal choroid plexus cysts represent a risk factor for aneuploidy when associated anomalies are present.

Keywords

Choroid plexus cyst, Amniocentesis, Trisomy, Chromosomal abnormality

References

• 1. Kraus I, Jirásek JE. Some observations of the structure of the choroid plexus and its cysts. Prenat Diagn. 2002;22(13):1223-1228. doi:10.1002/pd.486
• 2. Hurt L, Wright M, Dunstan F, et al. Prevalence of defined ultrasound findings of unknown significance at the second trimester fetal anomaly scan and their association with adverse pregnancy outcomes: the Welsh study of mothers and babies population-based cohort. Prenat Diagn. 2016;36(1):40-48. doi:10.1002/pd.4708
• 3. Demasio K, Canterino J, Ananth C, Fernandez C, Smulian J, Vintzileos A. Isolated choroid plexus cyst in low-risk women less than 35 years old. Am J Obstet Gynecol. 2002;187(5):1246-1249. doi:10.1067/mob.[phone]
• 4. Epelman M, Daneman A, Blaser SI, et al. Differential diagnosis of intracranial cystic lesions at head US: correlation with CT and MR imaging. Radiogr Rev Publ Radiol Soc N Am Inc. 2006;26(1):173-196. doi:10.1148/rg.261055033
• 5. Lopez JA, Reich D. Choroid plexus cysts. J Am Board Fam Med JABFM. 2006;19(4):422-425. doi:10.3122/jabfm.19.4.422
• 6. Coco C, Jeanty P. Karyotyping of fetuses with isolated choroid plexus cysts is not justified in an unselected population. J Ultrasound Med Off J Am Inst Ultrasound Med. 2004;23(7):899-906. doi:10.7863/jum.2004.23.7.899
• 7. Bronsteen R, Lee W, Vettraino IM, Huang R, Comstock CH. Second-trimester sonography and trisomy 18: the significance of isolated choroid plexus cysts after an examination that includes the fetal hands. J Ultrasound Med Off J Am Inst Ultrasound Med. 2004;23(2):241-245. doi:10.7863/jum.2004.23.2.241
• 8. Bernier FP, Crawford SG, Dewey D. Developmental outcome of children who had choroid plexus cysts detected prenatally. Prenat Diagn. 2005;25(4):322-326. doi:10.1002/pd.1135
• 9. Leitner Y, Goez H, Gull I, et al. Antenatal diagnosis of central nervous system anomalies: can we predict prognosis? J Child Neurol. 2004;19(6):435-438. doi:10.1177/088307380401900607
• 10. Yeo L, Guzman ER, Day-Salvatore D, Walters C, Chavez D, Vintzileos AM. Prenatal detection of fetal trisomy 18 through abnormal sonographic features. J Ultrasound Med Off J Am Inst Ultrasound Med. 2003;22(6):581-590; quiz 591-592. doi:10.7863/jum.2003.22.6.581
• 11. Singal K, Adamczyk K, Hurt L, Woolner A, Paranjothy S. Isolated choroid plexus cysts and health and developmental outcomes in childhood and adolescence - A systematic review. Eur J Obstet Gynecol Reprod Biol. 2023;290:115-122. doi:10.1016/j.ejogrb.2023.09.013
• 12. Benacerraf BR, Harlow B, Frigoletto FD. Are choroid plexus cysts an indication for second-trimester amniocentesis? Am J Obstet Gynecol. 1990;162(4):1001-1006. doi:10.1016/0002-9378(90)91304-u
• 13. Beke A, Barakonyi E, Belics Z, et al. Risk of chromosome abnormalities in the presence of bilateral or unilateral choroid plexus cysts. Fetal Diagn Ther. 2008;23(3):185-191. doi:10.1159/000116739
• 14. Sharma A, Dadhwal V, Rana A, Chawla J. Isolated large bilateral choroid plexus cysts associated with trisomy 18. BMJ Case Rep. 2019;12(3):e229216. doi:10.1136/bcr-2019-229216
• 15. Rotmensch S, Luo JS, Nores JA, Dimaio MS, Hobbins JC. Bilateral choroid plexus cysts in trisomy 21. Am J Obstet Gynecol. 1992;166(2):591-592. doi:10.1016/0002-9378(92)91680-9
• 16. Bromley B, Lieberman R, Benacerraf BR. Choroid plexus cysts: not associated with Down syndrome. Ultrasound Obstet Gynecol Off J Int Soc Ultrasound Obstet Gynecol. 1996;8(4):232-235. doi:10.1046/j.1469-0705.1996.08040232.x
• 17. Yoder PR, Sabbagha RE, Gross SJ, Zelop CM. The second-trimester fetus with isolated choroid plexus cysts: a meta-analysis of risk of trisomies 18 and 21. Obstet Gynecol. 1999;93(5 Pt 2):869-872. doi:10.1016/s0029-7844(98)00544-4
• 18. Gupta JK, Cave M, Lilford RJ, et al. Clinical significance of fetal choroid plexus cysts. Lancet Lond Engl. 1995;346(8977):724-729. doi:10.1016/s0140-6736(95)91502-8