Abstract
Objectives:
To determine maternal responses to detection of a minor structural variant, the choroid plexus cyst (CPC), in their fetus on prenatal ultrasound.
Study design:
We interviewed 34 pregnant women with an isolated CPC detected on mid-pregnancy ultrasound about their objective experience at diagnosis, emotional response and subsequent reactions. Audiotaped, transcribed responses were evaluated by two independent raters and analyzed qualitatively and quantitatively.
Results:
All women reported negative emotional responses including shock, distress, fear and decreased attachment, despite counseling by 82% of providers that the CPC was probably benign. Three women underwent amniocentesis purely for reassurance after CPC detection. Most (79%) sought information beyond what their physician provided, frequently on the internet. One half of women reported that intense negative responses were temporary. However, weeks after diagnosis, 62% continued to believe that the CPC presented some danger to their baby.
Conclusions:
Detection of CPC prenatally can evoke profound, negative maternal emotional responses despite accurate provider counseling. Practitioners should consider these responses when counseling parents about these and other structural variants of unclear functional significance.
Sponsor:
The Thomas Wilson Sanitarium for the Children of Baltimore City.
This is a preview of subscription content, access via your institution
Access options
Subscribe to this journal
Receive 12 print issues and online access
$259.00 per year
only $21.58 per issue
Buy this article
- Purchase on Springer Link
- Instant access to full article PDF
Prices may be subject to local taxes which are calculated during checkout
Similar content being viewed by others
References
Sahinoglu Z, Uludogan M, Sayar C, Turkover B, Toksoy G . Second trimester choroid plexus cysts and trisomy 18. Int J Gynaecol Obstet 2004; 85: 24–29.
Chitty LS, Chudleigh P, Wright E, Campbell S, Pembrey M . The significance of choroid plexus cysts in an unselected population: results of a multicenter study. Ultrasound Obstet Gynecol 1998; 12: 391–397.
Kupferminc MJ, Tamura RK, Sabbagha RE, Parilla BV, Cohen LS, Pergament E . Isolated choroid plexus cyst(s): an indication for amniocentesis. Am J Obstet Gynecol 1994; 171: 1068–1071.
Chinn DH, Miller EI, Worthy LM, Towers CV . Sonographically detected fetal choroid plexus cysts. Frequency and association with aneuploidy. J Ultrasound Med 1991; 10: 255–258.
Bronsteen R, Lee W, Vettraino IM, Huang R, Comstock CH . Second-trimester sonography and trisomy 18: the significance of isolated choroid plexus cysts after an examination that includes the fetal hands. J Ultrasound Med 2004; 23: 241–245.
DeVore GR . Second trimester ultrasonography may identify 77–97% of fetuses with trisomy 18. J Ultrasound Med 2000; 19: 565–576.
Ostlere SJ, Irving HC, Lilford RJ . Fetal choroid plexus cysts: a report of 100 cases. Radiology 1990; 175: 753–755.
Nyberg DA, Kramer D, Resta RG, Kapur R, Mahony BS, Luthy DA et al. Prenatal sonographic findings of trisomy 18: review of 47 cases. J Ultrasound Med 1993; 12: 103–113.
Gupta JK, Cave M, Lilford RJ, Farrell TA, Irving HC, Mason G et al. Clinical significance of fetal choroid plexus cysts. Lancet 1995; 346: 724–729.
Walkinshaw S, Pilling D, Spriggs A . Isolated choroid plexus cysts – the need for routine offer of karyotyping. Prenat Diagn 1994; 14: 663–667.
Brown T, Kliewer MA, Hertzberg BS, Ruiz C, Stamper TH, Rosnes J et al. A role for maternal serum screening in detecting chromosomal abnormalities in fetuses with isolated choroid plexus cysts: a prospective multicentre study. Prenat Diagn 1999; 19: 405–410.
Yoder PR, Sabbagha RE, Gross SJ, Zelop CM . The second-trimester fetus with isolated choroid plexus cysts: a meta-analysis of risk of trisomies 18 and 21. Obstet Gynecol 1999; 93 (5 Part 2): 869–872.
Ghidini A, Strobelt N, Locatelli A, Mariani E, Piccoli MG, Vergani P . Isolated fetal choroid plexus cysts: role of ultrasonography in establishment of the risk of trisomy 18. Am J Obstet Gynecol 2000; 182: 972–977.
Gratton RJ, Hogge WA, Aston CE . Choroid plexus cysts and trisomy 18: risk modification based on maternal age and multiple-marker screening. Am J Obstet Gynecol 1996; 175: 1493–1497.
Snijders RJ, Shawa L, Nicolaides KH . Fetal choroid plexus cysts and trisomy 18: assessment of risk based on ultrasound findings and maternal age. Prenat Diagn 1994; 14: 1119–1127.
Brumfield CG, Wenstrom KD, Owen J, Davis RO . Ultrasound findings and multiple marker screening in trisomy 18. Obstet Gynecol 2000; 95: 51–54.
Reinsch RC . Choroid plexus cysts – association with trisomy: prospective review of 16,059 patients. Am J Obstet Gynecol 1997; 176: 1381–1383.
Gross SJ, Shulman LP, Tolley EA, Emerson DS, Felker RE, Simpson JL et al. Isolated fetal choroid plexus cysts and trisomy 18: a review and meta-analysis. Am J Obstet Gynecol 1995; 172 (1 Part 1): 83–87.
Bromley B, Lieberman R, Benacerraf BR . Choroid plexus cysts: not associated with Down syndrome. Ultrasound Obstet Gynecol 1996; 8: 232–235.
Nadel AS, Bromley BS, Frigoletto Jr FD, Estroff JA, Benacerraf BR . Isolated choroid plexus cysts in the second-trimester fetus: is amniocentesis really indicated? Radiology 1992; 185: 545–548.
Sohn C, Gast AS, Krapfl E . Isolated fetal choroid plexus cysts: not an indication for genetic diagnosis? Fetal Diagn Ther 1997; 12: 255–259.
Geary M, Patel S, Lamont R . Isolated choroid plexus cysts and association with fetal aneuploidy in an unselected population. Ultrasound Obstet Gynecol 1997; 10: 171–173.
ACOG Practice Bulletin. Prenatal diagnosis of fetal chromosomal abnormalities. Obstet Gynecol 2001; 97 (S Part 1) Suppl 1–12.
Filly RA, Benacerraf BR, Nyberg DA, Hobbins JC . Choroid plexus cyst and echogenic intracardiac focus in women at low risk for chromosomal anomalies. J Ultrasound Med 2004; 23: 447–449.
Doubilet PM, Copel JA, Benson CB, Bahado-Singh RO, Platt LD . Choroid plexus cyst and echogenic intracardiac focus in women at low risk for chromosomal anomalies: the obligation to inform the mother. J Ultrasound Med 2004; 23: 883–885.
Burnard P . A method of analysing interview transcripts in qualitative research. Nurse Educ Today 1991; 11: 461–466.
StataCorp. Stata Statistical Software. Release 7.0 edn. Stata Corporation: College Station, TX, 2003.
Mitchell LM . Women's experiences of unexpected ultrasound findings. J Midwifery Womens Health 2004; 49: 228–234.
Leithner K, Maar A, Fischer-Kern M, Hilger E, Loffler-Stastka H, Ponocny-Seliger E . Affective state of women following a prenatal diagnosis: predictors of a negative psychological outcome. Ultrasound Obstet Gynecol 2004; 23: 240–246.
Sparling JW, Seeds JW, Farran DC . The relationship of obstetric ultrasound to parent and infant behavior. Obstet Gynecol 1988; 72: 902–907.
Santalahti P, Aro AR, Hemminki E, Helenius H, Ryynanen M . On what grounds do women participate in prenatal screening? Prenat Diagn 1998; 18: 153–165.
Eurenius K, Axelsson O, Gallstedt-Fransson I, Sjoden PO . Perception of information, expectations and experiences among women and their partners attending a second-trimester routine ultrasound scan. Ultrasound Obstet Gynecol 1997; 9: 86–90.
Watson MS, Hall S, Langford K, Marteau TM . Psychological impact of the detection of soft markers on routine ultrasound scanning: a pilot study investigating the modifying role of information. Prenat Diagn 2002; 22: 569–575.
Filly RA, Crane JP . Routine obstetric sonography. J Ultrasound Med 2002; 21: 713–718.
Marteau TM, Kidd J, Cook R, Michie S, Johnston M, Slack J et al. Psychological effects of having amniocentesis: are these due to the procedure, the risk or the behaviour? J Psychosom Res 1992; 36: 395–402.
Baillie C, Mason G, Hewison J . Scanning for pleasure. Br J Obstet Gynaecol 1997; 104: 1223–1224.
Laplante DP, Barr RG, Brunet A, Galbaud DU, Fort G, Meaney ML et al. Stress during pregnancy affects general intellectual and language functioning in human toddlers. Pediatr Res 2004; 56: 400–410.
Mulder EJ, Robles de Medina PG, Huizink AC, Van den Bergh BR, Buitelaar JK, Visser GH . Prenatal maternal stress: effects on pregnancy and the (unborn) child. Early Hum Dev 2002; 70: 3–14.
Paarlberg KM, Vingerhoets AJ, Passchier J, Dekker GA, Van Geijn HP . Psychosocial factors and pregnancy outcome: a review with emphasis on methodological issues. J Psychosom Res 1995; 39: 563–595.
Benoit D, Parker KC, Zeanah CH . Mothers' representations of their infants assessed prenatally: stability and association with infants' attachment classifications. J Child Psychol Psychiatry 1997; 38: 307–313.
Filly RA . Obstetrical sonography: the best way to terrify a pregnant woman. J Ultrasound Med 2000; 19: 1–5.
Baillie C, Hewison J . Antenatal screening. Obtaining selective consent to scanning, rather than screening, is possible. BMJ 1999; 318: 805.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Cristofalo, E., DiPietro, J., Costigan, K. et al. Women's response to fetal choroid plexus cysts detected by prenatal ultrasound. J Perinatol 26, 215–223 (2006). https://doi.org/10.1038/sj.jp.7211489
Received:
Revised:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1038/sj.jp.7211489
Keywords
This article is cited by
-
Indeterminate Prenatal Ultrasounds and Maternal Anxiety: A Prospective Cohort Study
Maternal and Child Health Journal (2021)
-
Exploring Adoption with Clients: The Need for Adoption Education Within the Genetic Counseling Profession
Journal of Genetic Counseling (2010)
-
Choroid plexus cysts do not affect fetal neurodevelopment
Journal of Perinatology (2006)