Parental decision-making differences between patients in two healthcare systems for choroid plexus cysts

Objective: We evaluated the medical-sociological implications of parental p erception of risk and decision-making choices for prenatally ascertained ch oroid plexus cysts (CPCs) between two obstetric populations with similar cl inical situations. Methods: The Wayne State University (WSU) Reproductive G enetics 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 anom alies. Results: 186 cases were identified in the WSU cohort, of whom 27 (15 %) declined invasive fetal testing. In the remaining 159 cases, aneuploidy was present in 2/132 (1.5%) isolated CPCs, 3/11 (27%) CPCs with AMA, and 15 /16 (93%) CPCs with multiple anomalies. 107 cases were identified in the MA MC cohort, of whom 99 (92%) declined invasive fetal testing. No cases of an euploidy were found in the 3/12 AMA cases or 5/95 non-AMA cases who underwe nt amniocentesis. Conclusions: The 2 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 c ontext may be as important as the genetic-prognostic risk for decision-maki ng. Copyright (C) 2000 S. Karger AG, Basel.