PREGNANCY-BIRTH Messages for October, 2001: Re: Question for Dr. Montgomery

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Re: Question for Dr. Montgomery

From: Lynn D. Montgomery, MD (anonymous@obgyn.net)
Wed, 31 Oct 2001 16:47:51 -0600 (CST)

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In reply to: Chris: "Question for Dr. Montgomery"

At Wed, 31 Oct 2001, Chris wrote: >
>Hi, I just found out today (18wks preg) that my baby has a choroid
>plexus cyst and 2 echogenic foci in the heart.
>
>I wasn't going to get an amnio due to the fact that I had 2 miscarriages
>previous to this pregnancy and I don't have any children. I'm 37.
>
>I'm afraid of the miscarriage risk from amnio. I had a laparoscapy to
>remove endo. about 11 mos. ago. This whole preg. has been a very
>sensitive one. If I'm on my feet for any significant time (1hr. plus)
>I get backaches and pain in my uterus.
>
>Do these things sound like they would put me at greater risk of
>miscarriage from an amnio?
>
>I am so scared to make a decision and I think I need to make it fast
>because I'm 18 weeks.
>
>I'm not sure how significant these markers are and what my chances of
>chromo abnormality is but I just don't know what to do.
>
>Any advice would be greatly appreciated. I am really messed up by this
>right now.
>
>Thanks. Chris
>
>--
>Chris
>

Chris, I can understand you concern and let me try to give you some information. Both of the findings you describe are referred to as "soft findings" for chromosomal abnormalities. By this, it means that there has been some correlation between noting them in a fetus and subsequently finding chromosomal abnormalities. However, they are just as stated-soft findings. In other words, the risk associated with either is quite low. For instance, with an isolated choroid plexus cyst, the risk is about 1%. If you use studies done by either Bennaceraf or Nyberg, by having the two findings in the same fetus, one should at least offer the option of amniocentesis to the patient. That brings us to the second issue. Whether or not to have an amnio depends on what you will do with the results. If you absolutely need to know what the baby's chromosomes are, then you should do the amnio. If the baby's chromosomes don't matter, then don't do it. Finally regarding the risks. I don't feel that your symptoms, etc, place you at any higher risk. The general risk of amniocentesis is 1 in 200 procedures. In the hands of a specialist in Maternal-Fetal Medicine, the risk is between 1 in 800 to 1 in 1000... Lynn

--
Lynn D. Montgomery, MD
Director, Maternal-Fetal Medicine
Rocky Mountain Perinatal Center
Missoula, Montana

**Note:  Opinions expressed here are for educational purposes only and, as such, do not constitute a physician-patient relationship.  This information is not intended to supplant the need for you to consult with your physician prior to choosing therapeutic options and/or interventions.

**Private e-mails cannot be entertained due to time constraints, consequently no private e-mails will receive a response.

**Thank you for your understanding ;-)

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