Transactions of the Twenty-Second Annual Meeting of the Society for Maternal-Fetal Medicine
Isolated choroid plexus cyst in low-risk women less than 35 years old

Presented at the Twenty-second Annual Meeting of the Society for Maternal-Fetal Medicine, New Orleans, La, January 14-19, 2002.
https://doi.org/10.1067/mob.2002.127463Get rights and content

Abstract

Objective: The purpose of this study was to determine the incidence of trisomy 18 in women who are <35 years old and who have sonographically detected isolated choroid plexus cyst. Study Design: A meta-analysis of prospective trials that were published in the English language between 1990 and 2000 was performed. Each trial met the following inclusion criteria: (1) prospective trial, (2) total population screened during the study period reported, (3) maternal age (either numeric or descriptive) reported, and (4) pregnancy/neonatal outcomes reported. An isolated choroid plexus cyst for the purpose of this study was defined as absence of sonographically detected structural abnormalities and normal serum analyte screens, if reported. Results: Eight trials met the criteria and were used for analysis. A total of 106,732 women were screened through articles that were published between 1990 and 2000. The total number of fetuses with choroid plexus cysts that were identified in second-trimester scans were 1235 (incidence, 1.2%). The incidence of isolated choroid plexus cysts in women who were <35 years old was 1.0% (n = 1017 women). There were no cases of trisomy 18 in women with isolated choroid plexus cyst who were <35 years old. Four structural abnormalities were noted on postnatal examination; all four neonates had normal karyotypes. Conclusion: There is no evidence that detection of isolated choroid plexus cyst in women who are <35 years of age increases the risk of trisomy 18. Therefore, amniocentesis is not warranted because of the inherent risk of pregnancy loss that is associated with the procedure. Better algorithms are needed to screen women who have a low risk for trisomy 18. (Am J Obstet Gynecol 2002;187:1246-9.)

Section snippets

Material and methods

A MEDLINE search of the databases of the National Library of Medicine was conducted with the use of the term choroid plexus cyst. Approximately 270 articles have been published on this topic, and approximately 100 of them are on prenatal diagnosis of choroid plexus cysts. We performed a meta-analysis only of articles that met four inclusion criteria. The first criterion was that the study be a prospective trial that had been published in the English language from 1990 through 2000. This time

Results

Thirteen prospective trials were published from 1990 through 2000.11, 12, 13, 14, 15, 16, 17, 18, 19, 20, 21, 22, 23 Eight of these trials met our inclusion criteria. Table I details included and excluded trials and gives the incidence of trisomy 18 cases in the screened population during the time period.

. Prospective trials that evaluated prenatal choroid plexus cyst 1990 through 2000

Included trials*Excluded trials†
Ghidini et al10 (2000)Gupta et al18 (1995)‡
Brown et al11 (1999)Kupferminc et al19

Comment

Prenatal diagnosis was provided historically to specific high-risk groups for known high-risk problems. The goal of this focus was to have a positive impact on pregnancies that are at a higher risk for complications without potentially increasing the risk to all pregnancies from the testing. The widespread availability of ultrasonography to both high- and low-risk women and the introduction of maternal serum analyte screening in low-risk women has enabled the detection of chromosomal

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