Case of Bilateral Choroid Plexus Cysts of Fetus

Homoeopathy is a Science based on Logic. In present century people want miracles in very short span of time. Also we can give miraculous results with Homoeopathy. The recent case with a single dose has really done miracle on the pathology of the baby in the womb, who yet don't have any self identity.19 yrs female Mrs. Azha Zahir Mohd. Momin, residing at Bhiwandi, married since 23/05/2009, educated upto 2 nd yr BSc, came on 25/11/2009 with chief complaint as below:

She is fair but lean thin & delicate. She has profuse perspiration since childhood. Her appetite is reduced since she is conceived as there is nausea & vomiting even at the smell of food. Thirst is less. She has Desires marked for Highly seasoned food3, Milk3, Cheese3, Sour3, Warm food3, Ice-cream3. Bowels are constipated; frequency of urination is increased especially at night. Sleep disturbed due to urination since a week. No dreams. She requires fanning throughout, takes luke warm water for bathing, takes 1 covering compulsory throughout the year, so thermally she is ambithermal.

P/H of Malaria in childhood & F/H Bro - (13 yrs old) - Muscular dystrophy since 4 yrs. MGM - Diabetes Mellitus, Mo - Spondylosis, PU - Tuberculosis.

Obstetric history is she is married on 23/05/2009; she is primigravida with h/o 5 months amenorrhoea. L.M.P. is 17/06/2009 & E.D.D. is 24/03/2010.

Life space: Her father is working in Municipality, Mother is House wife, 1 Elder sister married & 1 younger brother is totally dependent on Mother as he is having Muscular dystrophy. Her F-I-L is a Businessman, M-I-L is a House wife, B-I-L is studying in 11 th Std, 1 S-I-L is married & other has completed D. Pharmacy but is at home. Pts husband has done B.Com & I.C.A. and has a Mobile shoppy in Bhiwandi. She being very delicate always pampered & over protected by parents & being elder at inlaws place, is taken care of & pampered too being conceived. Her childhood was very happy without stress. She was average in studies but until get married father wants her to take education. She has completed her 2 nd year BSc and then got married. Has no ambition to continue the education ahead. She is very sensitive to slightest matters & reacts immediately by weeping. She doesn't mix easily with anybody, feels that she is lacking behind and is mismatch in the group. She has no say of her own; she is dependent on her inlaws for any decision (before marriage on parents). Also she is very slow at doing any work; she does the work told by her M-I-L but slowly. She has fear of dark and of being alone. Always needs somebody to accompany. Very mild & withdrawing, can't quarrel with anybody. Carries causeless anxiety for everybody, esp. her brother who has muscular dystrophy.

Actually after seeing her investigation reports her inlaws got a bit anxious & worried so they approached me. The investigation reports are as follows:

Investigations:

Sonography of Gravid Uterus:

Dt - 2 nd Nov 2009

The real time, B Mode, gray scale sonography was performed. Single live fetus is seen in changing position. Placenta is fundal posterior & shows grade 'I' maturity. Liquor is adequate for the gestational age. Internal os is closed at this stage. Cervical length measures 3.1 cm.

There is discontinuity noted in right choroid plexus with hypoechoic structure measuring 5mm noted within? Cyst formation.

Fetal movement & fetal cardiac pulsation well visualized. Fetal structure grossly appears normal.

Fetal heart rate - 146 BPM

Expected fetal weight - 236 (+/- 34) gm

Expected EDD - 03/04/2010 (+/- 15 days)

Impression:

• Single live intrauterine fetus in changing presentation with approximate gestational age "18 wks 2 days"
• Discontinuity in right choroid plexus with hypoechoic structure noted within? Cyst formation

 Dt - 3 rd Nov 2009

Targated Scan for Fetal Anomalies:

Single fetus is seen in uterus in changing position. Cardiac pulsations are well seen. Liquor is adequate. Placenta is fundal & along left lateral wall. Cervical length is 3.2 cm. Os is closed.

Target Scan reveals:

Bilaterally tiny choroid plexus cysts are seen. Right sided measures 3.0 mm & left sided measures 3.4 mm

Dt - 4 th Nov 2009

Alpha Feto Protein (AFP) - 110.46 IU/ml

Beta Human Chorionic Gonadotropin (BHCG) - 32,524.94 mIU/ml

Unconjugated Estriol (E-3) - 4.95 ng/ml

Treatment:

After studying the detail case history it striked my mind about two remedies, they are Calcrea carb & Baryta carb. After giving a thought I came to conclusion that her Constitutional remedy is Calcarea - carb as she is not backward or idiot like Baryta but, pampered, lazy, dependent & overprotectedlikeCalcarea. Also she has no say of her own and she is fearful & indecisive, this again points towards Calcarea.Acute remedy is Symphoricarpus (for Morning sickness)

On 25 th Nov 2009 she was given single dose of Calcarea - carb 200 & Placebo three times a day for a month. Symphoricarpus 1M was given and told to take as per necessity.

She was advised that her nightly frequency of urination is physiological and it will go on for whole of the gestational period. Her lumbo sacral pain also will be fluctuating. Need not worry but take rest when in pains. Do some non exertional work to keep self busy so that attention towards the complaint will be diverted. Take Symphoricarpus 1M SOS for nausea & vomiting.

Dt - 9 th Jan 2010

Targated Scan for Fetal Anomalies:

Single fetus is seen in vertex presentation with back to left. Cardiac pulsations are well seen. Liquor is adequate. Placenta is fundal and posterior. Cervical length is 3.1 cm. Os is closed.

Target Scan reveals:

Visualisation of fetal structures is suboptimal due to advanced gestational age

Comment:

• 28 wks gestation
• Fetal structures grossly appear normal
• Choroid plexus cyst seen earlier is now completely regressed

On 10 th Jan 2010 her M-I-L came with happy & surprise face showing the Sonography report of her D-I-L. She said her D-I-L didn't require Symphoricarpus till now and was only on the given three times a day medicine for a month, that too she has taken only twice daily as she used to forget sometimes the morning dose or sometimes the evening dose. Now she has been given again Placebo three times a day for another month and has been adviced that medicine is to be continued till the birth of baby to avoid further complications if any.