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Vol. 45. Núm. 1.
Páginas 8-15 (Enero 2002)
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Vol. 45. Núm. 1.
Páginas 8-15 (Enero 2002)
Acceso a texto completo
Quistes de plexos coroideos y riesgo de cromosomopatía
Choroid plexus cysts and risk of chromosomal anomalies
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26536
J.J. Montero Fanjul
Autor para correspondencia
jmonterof@sego.es

Correspondencia: Servicio de Obstetricia y Ginecología. Unidad de Ecografía y Diagnóstico Prenatal. Hospital Universitario Marqués de Valdecilla. Cazoña, s/n. 39011 Santander.
Servicio de Obstetricia y Ginecología. Unidad de Ecografía y Diagnóstico Prenatal. Hospital Universitario Marqués de Valdecilla. Santander.
Este artículo ha recibido
Información del artículo
Resumen
Introduccion

Desde su primera descripcion en 1984, la presencia de quistes de los plexos coroideos (QPC) en la gestacion ha suscitado un amplio debate en torno a su posible relacion con cromosomopatias, fundamentalmente la trisomia 18. Aun hoy persiste cierta controversia

Objetivo

Identificar que factores asociados (caracteristicas del quiste, anomalias asociadas y edad materna en el momento del diagnostico) deberian considerarse para justificar un estudio invasivo del cariotipo, teniendo en cuenta el riesgo de perdida fetal de estas tecnicas

Material y metodos

Se analizan los datos de una decada (enero de 1991-diciembre de 2000), correspondientes a 26.500 fetos examinados ecograficamente entre la 14 y 22 semanas de gestacion, considerandose como QPC una formacion econegativa de diametro ≥ 3mm alojada en el espesor del plexo coroideo

Resultados

Se detectaron 366 fetos portadores de QPC (1,38%). Entre estos, 8 presentaron una cromosomopatia, de los que 6 casos se correspondieron con una trisomia 18; otros dos casos fueron una trisomia 21 y una delecion p- del par 6. En los 8 casos, los QPC fueron bilaterales, se hallaron anomalias asociadas y la edad media materna fue de 36,5 anos

Conclusiones

Ante la presencia de QPC durante el segundo trimestre de la gestacion se impone la exploracion fetal detallada en busca de otros posibles marcadores de cromosomopatias, asumiendo que algunos son de dificil identificacion ecografica. En ausencia de estos y a la luz de nuestros resultados, estimado el riesgo de perdida fetal tras amniocentesis en el 1% de los casos, no parece justificada su practica en gestantes sin otros factores de riesgo anadidos

Palabras clave:
Quistes de plexos coroideos
Diagnóstico prenatal
Cromosomopatía
Trisomía 18
Abstract
Introduction

Since they were first described in 1984, the presence of choroid plexus cysts during pregnancy have stimulated considerable debate concerning their possible relationship with chromosomal anomalies, mainly trisomy 18. Even today, the controversy persists

Objective

To identify which associated factors (cyst characteristics, associated anomalies and maternal age at diagnosis) should be considered to justify invasive karyotyping, bearing in mind that these techniques carry a risk of fetal loss

Material and methods

We analyzed data from one decade (January 1991-December 2000) corresponding to 26,500 fetuses who underwent ultrasound examination between weeks 14 and 22 of gestation. Choroid plexus cysts were considered as an ultrasound-negative formation of at least 3mm in diameter located within the choroid plexus

Results

Choroid plexus cysts were found in 366 fetuses (1.38%). Of these, eight fetuses presented chromosomal anomalies: six presented trisomy 18, one presented trisomy 21 and one showed chromosomal deletion at 6p. In all eight patients, choroid plexus cysts were bilateral and associated anomalies were detected. Mean maternal age was 36.5 years

Conclusions

When choroid plexus cysts are detected in the second trimester, detailed fetal investigation must be performed to find other possible markers of chromosomal anomalies even though some are difficult to detect ultrasonographically. Because the risk of fetal loss after amniocentesis is estimated at 1%, when other markers are absent, our results suggest that invasive karyotyping does not seem justified in pregnant women without additional risk factors

Key words:
Choroid plexus cysts
Prenatal diagnosis
Chromosomal anomalies
Trisomy 18
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Bibliografía
[1.]
K.A. Kennedy, J.C. Carey.
Choroid plexus cysts: significance and current management practices.
Sem Ultrasound, CT MRI, 14 (1993), pp. 23-30
[2.]
P. Chudleigh, J. Pearce, S. Campbell.
The prenatal diagnosis of transient cyst of the fetal choroid plexus.
Prenat Diagn, 4 (1984), pp. 135-137
[3.]
J. Fitzsimmons, D. Wilson, J. Pascoe-Mason, C.h. Mei Shaw, D. Cyr, L. Mack.
Choroid plexus cysts in fetuses with trisomy 18.
Obstet Gynecol, 73 (1989), pp. 257-260
[4.]
N. Ricketts, E. Lowe, N. Patel.
Prenatal diagnosis of choroid plexus cysts.
Lancet, 1 (1987), pp. 213-214
[5.]
S. Gabrielli, A. Reece, G. Pilu, A. Perolo, N. Rizzo, L. Bovicelli, et al.
The clinical significance of prenatally diagnosed choroid plexus cysts.
Am J Obstet Gynecol, 160 (1989), pp. 1207-1210
[6.]
J. Thorpe-Beeston, C. Gosden, K. Nicolaides.
Choroid plexus cysts and chromosomal defects.
Br J Radiol, 63 (1990), pp. 783-786
[7.]
J.K. Gupta, M. Cave, R.J. Lilford, T.A. Farrell, H.C. Irwing, G. Mason, et al.
Clinical significance of fetal choroid plexus cysts.
Lancet, 346 (1995), pp. 724-729
[8.]
M. Geary, S. Patel, R. Lamont.
Isolated choroid plexus cysts and association with aneuploidy in an unselected population.
Ultrasound Obstet Gynecol, 10 (1997), pp. 171-173
[9.]
R.C. Reinsch.
Choroid plexus cysts-association with trisomy: prospoective review of 16,059 patiens.
Am J Obstet Gynecol, 176 (1997), pp. 1381-1383
[10.]
E. Denis, P. Dufour, A.S. Valat, P. Vaast, D. Subtil, P. Bourgeot, et al.
Kyste de plexus choroïde et risque d?anomalie chromosomique. Revue de la littérature et proposition de conduite à tenir.
J Gynecol Obstet Biol Reprod, 27 (1998), pp. 144-149
[11.]
C.L. Morcos, L.D. Platt, D.E. Carlsdon, K.D. Gregory, N.H. Greene, L.M. Korst.
The isolated choroid plexus cysts.
Obstet Gynecol, 92 (1998), pp. 232-236
[12.]
A. Ghidini, N. Strobelt, A. Locatelli, E. Mariani, M.G. Piccoli, P. Vergani.
Isolated fetal choroid plexus cysts: role of ultrasonography in establishment of the risk of trisomy 18.
Am J Obstet Gynecol, 182 (2000), pp. 972-977
[13.]
D. Hershey.
Fetal choroid plexus cysts [letter].
Obstet Gynecol, 73 (1989), pp. 301-302
[14.]
P. Twining, J. Zucollo, J. Clewes, J. Swallow.
Fetal choroid plexus cysts: a prospective study and review of the literature.
Br J Radiol, 64 (1991), pp. 98-102
[15.]
L. Platt, D. Carlson, A. Medearis, C. Walla.
Fetal choroid plexus cysts in the second trimester of pregnancy: a cause for concern.
Am J Obstet Gynecol, 164 (1991), pp. 1652-1656
[16.]
R. Achiron, G. Barkai, M. Katznelson, S. Mashiach.
Fetal lateral ventricle choroid plexus cyst: the dilemma of amniocentesis.
Obstet Gynecol, 78 (1991), pp. 815-818
[17.]
R. Howard, S. Tuck, J. Long, V. Thomas.
The significance of choroid plexus cysts in fetuses at 18-20 weeks.
An indication for amniocentesis? Prenat Diagn, 12 (1992), pp. 685-688
[18.]
S.J. Gross, L.P. Shulman, E.A. Tolley, D.S. Emerson, R.E. Felker, J.L. Simpson, et al.
Isolated fetal choroid plexus cysts and trisomy 18: A review and meta-analysis.
Am J Obstet Gynecol, 172 (1995), pp. 83-87
[19.]
M. Porto, Y. Murata, L. Warneke, K. Keegan.
Fetal choroid plexus cysts: an independent risk factor for chromosomal anomalies.
J Clin Ultrasound, 21 (1993), pp. 103-108
[20.]
M.J. Kupferminc, R.K. Tamura, R.E. Sabbaga, B.V. Parilla, L.S. Cohen, E. Pergament.
Isolated choroid plexus cyst(s): an indication for amniocentesis.
Am J Obstet Gynecol, 171 (1994), pp. 1068-1071
[21.]
R. Montemagno, P.W. Soothill, M. Scarcelli, C.H. Rodeck.
Disappearance of fetal choroid plexus cysts during the second trimester in cases of chromosomal anomality.
Br J Obstet Gynecol, 101 (1995), pp. 752-753
[22.]
B. Benacerraf, B. Harlow, F. Frigoletto.
Are choroid plexus cyst an indicatión for second-trimester amniocentesis?.
Am J Obstet Gynecol, 162 (1990), pp. 1001-1006
[23.]
M. Perpignano, H. Cohen, V. Klein, F. Mandel, J. Strelzoff, F. Chervenak, et al.
Fetal choroid plexus cysts: beware de smaller cyst.
Radiology, 182 (1992), pp. 715-717
[24.]
T. DeRoo, H. Harris, S. Sargent, T. Denholm, H. Crow.
Fetal choroid plexus cysts: prevalence, clinical significance and sonographic appearance.
Ajr, 151 (1988), pp. 1179-1181
[25.]
A. Rebaud, C. Chardon, M.F. Rebaud, M. Berland.
Dépistage anténatal des kystes des plexus choroïdes. Evolution et interprétation de 30 observations.
J Gynecol Obstet Biol Reprod, 21 (1992), pp. 665-670
[26.]
S. Clark, G. DeVore, P. Sabey.
Prenatal diagnosis of cyst of the fetal choroid plexus.
Obstet Gynecol, 72 (1988), pp. 585-586
[27.]
L. Chan, J. Hixson, S. Laifer, S. Marchese, J. Martin, L. Hill.
A sonographic and karyotypic study of second-trimester fetal choroid plexus cysts.
Obstet Gynecol, 73 (1989), pp. 703-705
[28.]
R. Snijders, S. Luma, K. Nicolaides.
Fetal choroid plexus cysts and trisomy 18: assessment of risk based on ultrasound findings and maternal age.
Prenat Diagn, 14 (1994), pp. 1119-1127
[29.]
S.A. Walkinshaw.
Fetal choroid plexus cysts: are we there yet?.
Prenat Diagn, 20 (2000), pp. 657-662
[30.]
L.E. Shields, S.B. Uhrich, T.R. Easterling, D.R. Cyr, L.A. Mack.
Isolated fetal choroid plexus cysts and karyotype analysis: is it necessary?.
J Ultrasound Med, 15 (1996), pp. 389-394
[31.]
S.A. Walkinshaw, D. Pilling, A. Spriggs.
Isolated fetal choroid plexus cysts. The need for routine offer of karyotyping.
Prenat Diagn, 14 (1994), pp. 663-667
[32.]
S. Rotmensch, J.-.S. Luo, J. Nores, M. Dimaio, J. Hobbins.
Bilateral choroid plexus cysts in trisomy 21.
Am J Obstet Gynecol, 166 (1992), pp. 591-592
[33.]
L.S. Chitty, P. Chudleihh, E. Wright, S. Campbell, M. Pembrey.
The significance of choroid plexus cysts in an unselected population: results of a multicenter study.
Ultrasound Obstet Gynecol, 12 (1998), pp. 391-397
[34.]
K. Nicolaides, C. Rodeck, C. Gosden.
Rapid caryotyping in nonlethal fetal malformations.
Lancet, 1 (1986), pp. 283-287
[35.]
S. Ostlere, H. Irving, R. Lilford.
Fetal choroid plexus cysts. A report of 100 cases.
Radiology, 175 (1990), pp. 753-755
[36.]
M. Furness.
Choroid plexus cysts and trisomy 18 [letter].
Lancet, 2 (1987), pp. 693
[37.]
U. Chitkara, C. Cogswell, K. Norton, I. Wilkins, K. Mehalek, R. Berkowitz.
Choroid plexus cysts in the fetus: a benign anatomic variant or pathologic entity? Report of 41 cases and review of the literature.
Obstet Gynecol, 72 (1988), pp. 185-189
Copyright © 2002. Sociedad Española de Ginecología y Obstetricia
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