Yhoshu Enono, Mahajan Jai Kumar, Singh Umesh Bahadur
Department of Pediatric Surgery, Advanced Pediatric Centre, Postgraduate Institute of Medical Education and Research, Room No 3130, PGIMER, Chandigarh, 160012, India.
Childs Nerv Syst. 2018 Dec;34(12):2449-2453. doi: 10.1007/s00381-018-3913-8. Epub 2018 Jul 15.
To assess the gestational course and postnatal outcome of antenatally diagnosed choroid plexus cysts.
From January 2015 to October 2017, mothers carrying foetuses with choroid plexus cysts (CPCs) were followed up prospectively till delivery, and subsequent postnatal assessment of all the babies was done. Progress of the lesions was monitored during pregnancy with ultrasound (USG) scans and postnatally analysed with clinical assessment and USG examination of the cranium.
A total of 67 mothers of antenatally diagnosed CPCs were referred to the Paediatric Surgery Unit for opinion. Mean gestational age at the time of diagnosis was 19 ± 2.1 weeks (17-28 weeks) while mean age of the mothers at the time of referral was 26 ± 3.3 years (19-35 years). Sixty four mothers have undergone repeat antenatal scans after the diagnosis, and the CPCs disappeared completely in 60 (93.8%) of them. The CPCs persisted but reduced in size in 2 (4.1%), and the other 2 have been lost to follow-up. Thirty eight patients (56.7%) have unilateral CPCs. Mean size of cysts is 6.08 ± 3.0 mm (2.4‑14.8 mm). One foetus, in which the CPC disappeared antenatally, developed it again on the postnatal scans, but is doing well on follow-up. Thirteen babies (19.4%) have other associated congenital malformations as well.
CPCs may involve one or both ventricles and disappear in approximately 95% of the cases, mostly within 2 months from the diagnosis. The size of the cyst has no relation to its rate of disappearance. Postnatal persistence of CPCs is uncommon and the neurological sequel is unlikely; hence, prospective parents should be reassured accordingly.
评估产前诊断的脉络丛囊肿的妊娠过程及产后结局。
2015年1月至2017年10月,对怀有脉络丛囊肿(CPC)胎儿的母亲进行前瞻性随访直至分娩,并对所有婴儿进行产后评估。孕期通过超声(USG)扫描监测病变进展,产后通过临床评估和头颅USG检查进行分析。
共有67例产前诊断为CPC的母亲被转至小儿外科征求意见。诊断时的平均孕周为19±2.1周(17 - 28周),转诊时母亲的平均年龄为26±3.3岁(19 - 35岁)。64例母亲在诊断后进行了重复产前扫描,其中60例(93.8%)的CPC完全消失。2例(4.1%)的CPC持续存在但体积缩小,另外2例失访。38例患者(56.7%)有单侧CPC。囊肿的平均大小为6.08±3.0mm(2.4 - 14.8mm)。1例胎儿的CPC在产前消失,但产后扫描时再次出现,不过随访情况良好。13例婴儿(19.4%)还伴有其他先天性畸形。
CPC可能累及一个或两个脑室,约95%的病例会消失,大多在诊断后2个月内。囊肿大小与其消失速度无关。CPC产后持续存在的情况不常见,发生神经后遗症的可能性不大;因此,应相应地让准父母放心。