At our standard 19 week ultrasound we were informed that our fetus registered a brain abnormality. The sonographer noted the presence of choroid plexus cysts (CPCs) on the bilateral regions of the brain. CPCs are not a huge problem in and of themselves. They are located in the fluid around the brain, not in the areas that control personality or function. Though they are rare (found in 1-2% of pregnancies) many people have them their whole lives. It’s even more likely that these CPCs will disappear by 24 weeks, as is the case in 99% of instances where they are seen. Our midwife was visibly disgusted that these were even noted on our chart since they generally amount to nothing more than unease and worry for the parents, all unnecessary.
The major issue with CPCs is that they can be a soft marker of a chromosomal difference in the fetus. I say “can” because these abnormalities usually coincide with other factors, like higher maternal age, heart problems or physical features associated with a particular chromosomal abnormality. The more worrisome chromosomal copy is Trisomy 18, or Edwards syndrome, a fatal genetic disorder that ends in the the stillbirth of 50% of babies. The 50% who make it to term usually die within days of delivery, of apnea or heart failure. We did not see any of the characteristic of Edwards syndrome (crossed legs, clenched fists, bowels external to the body) in our fetus. Trisomy 21, or Down syndrome, is less associated with CPCs but is still a possibility. Trisomy 21 is not as big a concern for us since our fetus exhibits none of the physical ailments associated that cause physical suffering to our child (heart problems, kidney function, or being severely underweight).
We will have a Level II ultrasound in four weeks to identify any physical issues not seen at the standard ultrasound and to see if the CPCs have grown or disappeared. We would like to be prepared for the kind of care a high-needs baby would require, both for ourselves and for the infant. This ultrasound may also eliminate entirely the possibility of a chromosomal condition. Even if the CPCs remain there is a 99% chance our fetus is chromosomally average. Regardless of the results we will not request an amniocentisis because of the small but present concern of miscarriage. We do not participate in prenatal genetic screening so that information is unavailable to us.
This news is sobering but certainly, at this point, not a source of panic or even worry. If anything the very slightly heightened possibility of bearing a child with a chromosomal abnormality (perhaps) has brought the bioethical news of the previous few weeks into even clearer focus. A few “of note” developments have occurred. A blood test was introduced that can accurately predict the sex of a baby at seven weeks. The Danes introduced an initiative to completely eliminate Down syndrome babies through selective abortion, calling this outcome a “fantastic achievement.” The NYTimes reported on the rise in reductions of a healthy twin in order to produce a singelton pregnancy. The world feels less safe for children who are seen as undesirable by nature of their chromosomes, sex or their being part of a multiple pregnancy. We’re praying for the grace, community and patience to love, for as long as we are granted, whatever gift we receive. Of one thing we are certain – the gratuitous love of our God. And for that we rejoice.