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

We evaluated the medical-sociological implications of parental perception o f risk and decision-making choices for prenatally ascertained choroid plexu s cysts (CPC) between two obstetric populations. The Wayne State University (WSU) Reproductive Genetics database and the Mad igan Army Medical Center (MAMC) experience were reviewed to compare the rat es of aneuploidy and invasive testing for cases with CPC. Aneuploidy rates were compared between those with isolated CPC, CPC with advanced maternal a ge (AMA), and CPC associated with multiple anomalies. In the WSU cohort 186 cases were identified, of whom 27 (15%) declined inva sive fetal testing. In theremaining 159 cases, aneuploidy was present in 2/ 132 (1.5%) isolated CPC, 3/11 (27%) CPC with AMA, and 15/16 (93%) CPC with multiple anomalies. In the MAMC cohort 107 cases were identified, of whom 99 (92%) declined inv asive fetal testing. No aneuploidy cases were found in the 3/12 AMA cases o r 5/95 non-AMA cases that underwent amniocentesis. The two cases of aneuplo idy with isolated CPC cannot be ignored, and provide an estimated attributa ble risk of at least 0.8%, a higher risk than 38 years of age. However, the parental sociologic context may be as important for decision-making as the genetic-prognostic risk.