Outcome of isolated fetal choroid plexus cyst detected in prenatal sonography among infertile patients referred to Royan Institute: a 3-year study

Several studies have assessed the correlation of fetal choroid plexus cyst [CPC] and the risk of congenital anomalies, but few ones have discussed isolated CPC [with no other abnormal sonographic finding]. The aim of this study was to determine the outcome of isolated fetal choroid plexus cyst and to specify its clinical significance. This cross sectional study was carried out at Royan Institute in Tehran, Iran, between April 2009 and December 2012. All prenatal sonographies in this period of time were assessed using a computerized database and fetuses who had isolated CPC were recruited in the study. Sonography reports, mother serum screening test results, fetal echocardiography and amniocentesis were evaluated until birth. A follow-up phone call was made to all individuals to learn about the neonatal outcomes. Overall, 6240 prenatal sonographies were performed in this setting during this period. Isolated CPC was detected in 64 fetuses. The results of double test [N=30], triple test [N=5] and fetal echocardiography [N =24] were normal. Quadruple test result showed 3 abnormal out of 29 cases that all had normal karyotypes. Four samples were dropped out due to premature rupture of membranes [N=3] and intrauterine fetal death [N=1]. It was found that the outcomes of all remaining fetuses [N=60] were normal and no anomaly ones were seen until birth. Isolated CPC is a benign regressive condition with no clinical significance

Comparison of two dimensional and live three dimensional ultrasounds for the diagnosis of septated uterus

Background: Traditionally, septate uterus was diagnosed with invasive method like hysterosalpingography and hysteroscopy. Nowadays transvaginal ultrasonography was reported to be a sensitive tool for detection of septate uterus too

Objective: The objective of the present study was to evaluate the application of two dimensional ultrasound [2-DUS] and real time three dimensional ultrasound [3-DUS] in differentiating various type of septated uterus. Hysteroscopy confirmation was assigned as the gold standard

Materials and Methods: This retrospective study was performed among 215 infertile women with suspected septate uterus from October 2008 to July 2012. An inclusion criterion was septated uterus based on HSG or experiencing abortion, preterm labor, or recurrent IVF failure. Fusion anomalies were excluded from the study [unicornuate, bicornuate and didelphys anomalies]. The results of 3D and 2D sonographies were compared, while they were confirmed by hysteroscopy result in detection of septated uterus. Kappa index for agreement between 2DUS and hysteroscopy, as well as 3-DUS and hysteroscopy in detection of septate uterus was carried out. By receiver operating characteristic [ROC] curve, cut off points for predicting the kind of anomalies were proposed

Results: The women were evaluated by 2-DUS [n=89] and [II] 3-DUS [n=126]. All women underwent hysteroscopy, following 2-DUS and 3-DUS at the same or subsequent cycle. The results of kappa [K] index were 0.575 and 0.291 for 3-DUS and hysteroscopy, as well as 2-DUS and hysteroscopy, respectively. Also, the cutoff points were 27% for arcuate and subseptate, and 35% for differentiating septate and subseptate

Conclusion: Real time 3-DUS has better ability for visualization both uterine cavity and the fundal uterine, so it has higher agreement in detection of septate uterus than 2-DUS