31 yrs old primi at 22 wks GA with triple marker showing low risk for trisomy 18,21 and neural tube defects.anomaly scan done at 18 wks shows single small choroid plexus cyst of 0.6 cm with no other asssociated major congenital anomaly, umbilical cord showing normal two arteries and one vein.Family history of mental retardation of sister in law present.patient wants to know her risks of having a mentally retarded baby so that she can decide whether to continue or terminate the pregnancy. In my opinion since there is no other congenital anomaly associated other than choroid plexus cyst , she must continue with the pregnancy as most resolve around 28 wks, repeat scan advised to note for the size of cyst. should i advice her for amniocentesis? and what is the medicolegal significance of the case? kindly give your valuable opinion. USG pictures of the cyst are attached.



The presence of choroid cyst and the h/of anomalies in brothers's wife or husband s Brother's wife(Bhabi ) is no concern. This cannot cause M. R. Just follow up by U. S

h/o mental retardation of husband's sister is present.

U r right,if triple shows low risk of trisomies amnio not indicated,As far as mental retardation history is concerned evaluate the affected members whether suffering from Downs ,if Downs affection present do a quadruple or give option of amnio ,if not demarcable cause no need to evaluate further.

My opinion is that amniocentesis should always be given to a couple who has a family history of mental retardation and is really concerned about the mental health of the baby though choroid plexus cyst resolves usually... Later if anything goes wrong then the patient can say that why was it not recommended to us...

only reassurance. ...nothing else is indicated

pt shows choroid plexus cyst with no other abn in anamoly scan normal markers there is no Ind of amniocentesis or termination of preg reassure the pt

continue same, continue pregnancy with frequent USG scans at 4weeks interval, postnatal neurosonogram will tell us what to do, most of the cases just needs follow up, but if there is any agenisis or malformations we may need to go for termination

If triple marker and anomaly scan is normal tha amniocentesis should not be required

agree with Dr rolika

only f/u scan should be done n pregnancy should be continued

choroid plexus cyst is a benign cyst and considered as soft marker. if there's no other anomaly, Trisomy 18 risk is only 1%. Along with the anomaly scan serum markers can be advised in 2nd trimester. Amniocentesis to be done if these markers are abnormal.

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