Choroidal cysts occur in about 3% of fetuses around the middle of pregnancy, but most of them disappear on their own by 24 weeks. Some studies have shown that fetuses with cysts have a slightly higher chance of having chromosomal abnormalities (especially trisomy 18), but most of these fetuses with chromosomal abnormalities have other major abnormalities in addition to the cysts,
In addition to cysts, most of the fetuses with chromosomal abnormalities are associated with other major abnormalities. Therefore, the current management of such cysts is that the fetus with choroidal cysts should be followed up by ultrasound: 1.
2. If there is no other abnormality, the maternal examination will be performed in the same way as normal pregnant women, and the fetus will have the same developmental intelligence as normal fetuses.
It is recommended to wait until 26-28 weeks of pregnancy to do a 4D ultrasound review, the image is clear and three-dimensional, which can provide better reference. Choroid plexus cyst definition.
Choroid plexus cysts are small, scattered, ≥3 mm diameter cysts detected by ultrasound in the lateral ventricular choroid plexus in developing fetuses at 14-24 weeks of gestational age. More than 90% of fetal choroid plexus cysts disappear after 26 weeks of gestation, with only a few increasing in size progressively.
When choroid plexus cysts are detected, amniocentesis amniotic fluid culture or umbilical cord puncture for umbilical cord blood culture should be performed in conjunction with other clinical data to exclude chromosomal abnormalities such as trisomy 18 and trisomy 21.
Choroid plexus cysts can also appear in normal fetuses, but most of them resolve after 26 weeks. If they do not resolve after 26 weeks and are bilateral, a cranial examination and chromosomal examination of the umbilical cord blood cells should be done after the birth of the child.
If it disappears, there will be no compression or increased brain pressure, and the intelligence or other aspects of the child’s life will not be affected by the “bilateral choroid plexus cysts” after birth. Ultrasound diagnosis 1. Cystic dark areas are seen within the strong echogenicity of the choroid plexus, with thin walls and smooth, neat edges, mostly round. Cysts can be single or multiple. 2, dynamic observation of cyst size, if the cyst is less than 1CM or getting smaller, chromosomal abnormalities are less likely, and attention should be paid to check whether new malformations appear in other parts, sometimes after ultrasound detects choroid plexus cysts, other malformations cannot be detected yet. However, some scholars believe that the risk of chromosomal abnormalities in the fetus will not change with the size, number, bilateral or unilateral, and whether the choroid plexus cysts are progressively shrinking or disappearing. When choroid plexus cysts are detected, further amniocentesis with amniotic fluid cells or umbilical cord puncture blood culture should be performed in combination with other clinical data to exclude chromosomal abnormalities such as trisomy 18 and trisomy 21.
Prognosis.
Choroid plexus cysts alone often have no clear pathological significance and have a good prognosis. However, fetal choroid plexus cysts are associated with an increased risk of chromosomal abnormalities (trisomy 18, trisomy 21, etc.). Ma Xiangtao, Department of Pediatrics, Anyang Third People’s Hospital