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Updated: Aug 8, 2026
Manual Segmentation of the Human Choroid Plexus Using Brain MRI
Published on: December 15, 2023
Parental decision-making differences between patients in two healthcare systems for choroid plexus cysts
C C Apodaca1, R F Hume, W J Evans
1Department of Obstetrics and Gynecology, Madigan Army Medical Center, Tacoma, Washington 98431, United States of America.
Insights
Parental perception of risk influences decisions for fetuses with choroid plexus cysts (CPC). Sociological factors may be as critical as genetic risks in these prenatal diagnoses.
Area of Science:
- Perinatology
- Medical Sociology
- Prenatal Genetics
Background:
- Choroid plexus cysts (CPC) are common prenatal findings.
- Parental decision-making regarding invasive testing is influenced by perceived risk.
- Understanding medical-sociological implications is crucial for genetic counseling.
Purpose of the Study:
- To evaluate medical-sociological factors in parental decision-making for prenatally diagnosed CPC.
- To compare aneuploidy rates and invasive testing uptake between two obstetric populations.
- To assess the risk of aneuploidy in isolated CPC versus CPC with advanced maternal age or multiple anomalies.
Main Methods:
- Retrospective review of the Wayne State University (WSU) Reproductive Genetics database and Madigan Army Medical Center (MAMC) experience.
- Comparison of aneuploidy rates and invasive testing decisions for cases with CPC.
- Analysis of aneuploidy rates stratified by isolated CPC, CPC with advanced maternal age (AMA), and CPC with multiple anomalies.
Main Results:
- In the WSU cohort, 15% declined invasive testing. Aneuploidy rates were 1.5% for isolated CPC, 27% for CPC with AMA, and 93% for CPC with multiple anomalies.
- In the MAMC cohort, 92% declined invasive testing. No aneuploidy was detected in tested cases.
- Two cases of aneuploidy with isolated CPC yielded an attributable risk of at least 0.8%, exceeding the risk associated with AMA.
Conclusions:
- The attributable risk of aneuploidy in isolated CPC may be higher than previously estimated.
- Parental sociologic context and risk perception significantly influence decisions regarding invasive prenatal testing.
- Integrating medical-sociological insights with genetic-prognostic information is essential for comprehensive prenatal counseling.
Abstract:
We evaluated the medical-sociological implications of parental perception of risk and decision-making choices for prenatally ascertained choroid plexus cysts (CPC) between two obstetric populations. The Wayne State University (WSU) Reproductive Genetics database and the Madigan Army Medical Center (MAMC) experience were reviewed to compare the rates of aneuploidy and invasive testing for cases with CPC. Aneuploidy rates were compared between those with isolated CPC, CPC with advanced maternal age (AMA), and CPC associated with multiple anomalies. In the WSU cohort 186 cases were identified, of whom 27 (15%) declined invasive fetal testing. In the remaining 159 cases, aneuploidy was present in 2/132 (1.5%) isolated CPC, 3/11 (27%) CPC with AMA, and 15/16 (93%) CPC with multiple anomalies. In the MAMC cohort 107 cases were identified, of whom 99 (92%) declined invasive fetal testing. No aneuploidy cases were found in the 3/12 AMA cases or 5/95 non-AMA cases that underwent amniocentesis. The two cases of aneuploidy with isolated CPC cannot be ignored, and provide an estimated attributable risk of at least 0.8%, a higher risk than 38 years of age. However, the parental sociologic context may be as important for decision-making as the genetic-prognostic risk.
