Learning Objectives and CME/Disclosure Information
This activity is intended for healthcare providers delivering care to women and their families.
After completing this activity, the participant should be better able to:
1. Discuss how choroid plexus cysts arise 2. Determine the next steps to take after a choroid plexus cyst is noted of sonogram
Estimated time to complete activity: 0.25 hours
Susan J. Gross, MD, FRCSC, FACOG, FACMG
President and CEO, The ObG Project
Disclosure of Conflicts of Interest
Postgraduate Institute for Medicine (PIM) requires faculty, planners, and others in control of educational content to disclose all their financial relationships with ineligible companies. All identified conflicts of interest (COI) are thoroughly vetted and mitigated according to PIM policy. PIM is committed to providing its learners with high quality accredited continuing education activities and related materials that promote improvements or quality in healthcare and not a specific proprietary business interest of an ineligible company.
The PIM planners and others have nothing to disclose. The OBG Project planners and others have nothing to disclose.
Faculty: Susan J. Gross, MD, receives consulting fees from Cradle Genomics, and has financial interest in The ObG Project, Inc.
Planners and Managers: The PIM planners and managers, Trace Hutchison, PharmD, Samantha Mattiucci, PharmD, CHCP, Judi Smelker-Mitchek, MBA, MSN, RN, and Jan Schultz, MSN, RN, CHCP have nothing to disclose.
Method of Participation and Request for Credit
Fees for participating and receiving CME credit for this activity are as posted on The ObG Project website. During the period from Dec 31 2017 through Jan 25 2023, participants must read the learning objectives and faculty disclosures and study the educational activity.
If you wish to receive acknowledgment for completing this activity, please complete the post-test and evaluation. Upon registering and successfully completing the post-test with a score of 100% and the activity evaluation, your certificate will be made available immediately.
For Pharmacists: Upon successfully completing the post-test with a score of 100% and the activity evaluation form, transcript information will be sent to the NABP CPE Monitor Service within 4 weeks.
Joint Accreditation Statement
In support of improving patient care, this activity has been planned and implemented by the Postgraduate Institute for Medicine and The ObG Project. Postgraduate Institute for Medicine is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team.
Physician Continuing Medical Education
Postgraduate Institute for Medicine designates this enduring material for a maximum of 0.25 AMA PRA Category 1 Credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.
Continuing Nursing Education
The maximum number of hours awarded for this Continuing Nursing Education activity is 0.2 contact hours.
The fetal choroid plexus produces CSF that leads to the normal expansion and development of the ventricular system. In some cases, fluid may get trapped, leading to the identification of choroid plexus cysts (CPCs) during prenatal ultrasound. The natural history of CPCs is resolution by 28 weeks. CPCs are not considered a structural brain abnormality, but are present in fetuses with trisomy 18 along with other multiple anomalies. An isolated CPC is a common finding in euploid fetuses.
Determining the Significance of CPCs
If CPCs are detected, a detailed anatomical study should be performed to identify other structural anomalies and findings associated with Trisomy 18 such as heart defects, abnormalities in the hands (“clenched fists”) and feet (“rocker-bottom”), growth restriction with polyhydramnios
If CPCs are seen in isolation with no other fetal abnormalities on ultrasound
If aneuploidy screening has not been performed
Offer screening options (NIPS or quad screen if NIPS not available or too expensive)
If screening result is negative, no further aneuploidy evaluation or follow up ultrasound is recommended
If aneuploidy screen result is positive, refer for genetic counseling and consideration of diagnostic testing options
If other anomalies or findings associated with Trisomy 18 are present on fetal ultrasound
Genetic counseling and offering diagnostic testing with amniocentesis is indicated
Note: SMFM guidance does not recommend diagnostic testing for isolated soft markers if aneuploidy screening is negative, but supports offering diagnostic testing as an option to all pregnant people regardless of aneuploidy risk
Choroid plexus cysts are present in 1 to 2% of all fetuses in the 2nd trimester and are due to CSF trapped in the choroid plexus(es). They may be single, multiple, unilateral or bilateral. CPCs are associated with trisomy 18, not Trisomy 21. CPCs generally resolve and if found in isolation are considered a normal variant.
No increased risk of neurodevelopmental delay in genetically normal fetuses with CPCs
No need for prenatal or postnatal follow-up of isolated CPCs
OBG Project CME requires a modern web browser (Internet Explorer 10+, Mozilla Firefox, Apple Safari, Google Chrome, Microsoft Edge). Certain educational activities may require additional software to view multimedia, presentation, or printable versions of their content. These activities will be marked as such and will provide links to the required software. That software may be: Adobe Flash, Apple QuickTime, Adobe Acrobat, Microsoft PowerPoint, Windows Media Player, or Real Networks Real One Player.
Disclosure of Unlabeled Use
This educational activity may contain discussion of published and/or investigational uses of agents that are not indicated by the FDA. The planners of this activity do not recommend the use of any agent outside of the labeled indications.
The opinions expressed in the educational activity are those of the faculty and do not necessarily represent the views of the planners. Please refer to the official prescribing information for each product for discussion of approved indications, contraindications, and warnings.
Participants have an implied responsibility to use the newly acquired information to enhance patient outcomes and their own professional development. The information
presented in this activity is not meant to serve as a guideline for patient management. Any procedures, medications, or other courses of diagnosis or treatment discussed or suggested in this activity should not be used by clinicians without evaluation of their patient’s conditions and possible contraindications and/or dangers in use, review of any applicable manufacturer’s product information, and comparison with recommendations of other authorities.
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