Sada je: 03 ruj 2014, 08:57.
I am 20 weeks pregnant and my baby may have bilateral choroid plexus cysts. A second ultrasound is scheduled. What causes CPCs and what are potential effects on the baby when CPCs have disappeared and when they have not?
These type of cysts can be a normal phenomenon and can regress spontaneously. I have received many letters from mothers who had such a diagnosis and worried their entire pregnancies or until another ultrasound showed resolution.
The incidence of these cysts seems to be about one percent. Some seem to be associated with genetic problems such as trisomy 18 and can be a marker for other types of chromosomal problems. Some authors do not recommend amniocentesis, but feel it should be offered. Because these cysts often resolve, many unnecessary amnios would be done if they were performed in all of these cases. Ultrasound can detect other markers and signs such as "nuchal (neck) thickness," which is more indicative of a trisomy problem. If there are accompanying indications in addition to the cysts, then the benefits of amniocentesis may well outweigh the risks.
What is a Choroid Plexus Cyst?
The choroid plexus is an area of the brain that is not involved thinking or personality. Rather, the choroid plexus makes a fluid that protects and nourishes the brain and spinal cord. When a fluid-filled space is seen in the choroid plexus during an ultrasound, it is called a choroid plexus cyst (CPC). "We don't know why, but between 1 and 3 percent of all fetuses will manifest a CPC at 16 to 24 weeks of pregnancy," says Dr. Roy A. Filly, a Professor of Radiology and of Obstetrics, Gynecology and Reproductive Sciences and Chief of the Section of Diagnostic Sonography at University of California, San Francisco. CPCs can be found either on one side of the brain (unilateral) or both sides (bilateral). They can vary in size and shape, from small and round to large and irregular. Some fetuses have more than one.
Regardless of their number, shape or size, choroid plexus cysts are not harmful to the baby. "I am not aware of a single instance where a CPC caused damage to a fetus," says Dr. Filly.
Dr. Peter Doubilet, a Professor of Radiology at Harvard Medical School, agrees, "That's one very important fact. CPCs are not harmful, and they nearly always go away by the third trimester of pregnancy."
If CPCs are found during an ultrasound, the radiologist will scrutinize every organ and body part to look for other abnormalities, such as a malformed heart, head, hands or feet, and stunted growth of the baby. When no other abnormalities are found, the diagnosis is called an "isolated CPC."
The Significance of an Isolated CPC
If CPCs do not cause any damage, why does anyone worry about them? The problem is really one of association—being at the wrong place at the wrong time. Wrong or right, CPCs have become associated with a severe genetic disease called Trisomy 18. It is well documented that about half of babies with Trisomy 18 show a CPC on ultrasound. But Dr. Bronsteen from the Division of Fetal Imaging at William Beaumont Hospital in Royal Oak, Michigan points out, "Nearly all babies with Trisomy 18 who have a CPC have other abnormalities on the ultrasound, especially in the heart, hand, and foot." The real question arises when a baby has a CPC with nothing else wrong: the "isolated CPC."
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