Diagnostic accuracy, work-up, and outcomes of pregnancies with clubfoot detected by prenatal sonography.

Abstract:

OBJECTIVE:To assess diagnostic accuracy, related findings, and outcomes of fetuses with clubfoot. METHODS:Sonographic characteristics, pregnancy work-up, and postnatal outcomes were evaluated in 109 fetuses with clubfoot. RESULTS:Among 40 320 prenatal ultrasound anomaly scans, clubfoot was diagnosed in 150 (0.37%). Analysis included 108 pregnancies (72%) with 109 fetuses. Bilateral clubfoot was diagnosed in 51/109 (46.7%) fetuses and unilateral in 58/109 (53.2%). Clubfoot was diagnosed as an isolated anomaly in 76/109 (69.7%) and complex in 33/109 (30.2%). Amniocentesis or chorionic villus sampling in 48/109 (44%) yielded 6 (12.5%) with abnormalities (5.5% of the entire cohort). Diagnosis was confirmed in 65/91 (71.4%) liveborn infants. In singletons, 7/63 (11.1%) cases considered isolated on ultrasound had additional anomalies postpartum and 8/14 (57.1%) complex cases were verified after birth. Sonographic diagnosis of clubfoot was verified postpartum in more singletons than twins (p = 0.05). Bilateral clubfoot was verified postpartum more often than unilateral [29/33 (87.9%) vs. 29/44 (65.9%), respectively; p = 0.03]. Bilateral clubfoot resulted in additional prenatal testing without increased likelihood of finding additional anomalies and was associated with more surgical interventions postnatally. CONCLUSIONS:Prenatal ultrasound diagnosis of clubfoot is more accurate in singletons with bilateral findings. Bilateral findings do not increase the likelihood of additional anomalies. Karyotyping should be considered even with isolated clubfoot. © 2017 John Wiley & Sons, Ltd.

journal_name

Prenat Diagn

journal_title

Prenatal diagnosis

authors

Sharon-Weiner M,Sukenik-Halevy R,Tepper R,Fishman A,Biron-Shental T,Markovitch O

doi

10.1002/pd.5077

subject

Has Abstract

pub_date

2017-08-01 00:00:00

pages

754-763

issue

8

eissn

0197-3851

issn

1097-0223

journal_volume

37

pub_type

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