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Prenatal Diagnosis of Clubfoot: A Review of Current Available Methodology
Cesare Faldini1, Domenico Fenga2, Ilaria Sanzarello2
1Rizzoli Orthopaedic Institute, University of Bologna, Italy
Insights
Prenatal diagnosis of clubfoot, a common congenital limb deformity, is best achieved through ultrasonography between 18-24 weeks of gestation. Early detection enables timely intervention and monitoring for associated abnormalities.
Area of Science:
- Medical Imaging
- Prenatal Medicine
- Orthopedics
Background:
- Clubfoot is a frequent congenital limb malformation.
- Prenatal diagnosis is crucial for early treatment of clubfoot.
- This review examines current prenatal diagnostic methods for clubfoot.
Purpose of the Study:
- To review the literature on prenatal diagnosis of clubfoot.
- To identify the most effective methods for detecting clubfoot in utero.
Main Methods:
- Literature search of major databases (PubMed, OVID, Cochrane, CINAHL, Google Scholar, Embase) from 1966 to 2015.
- Screening of 197 retrieved articles, with full-text review of 39 articles and reference list screening.
Main Results:
- Ultrasonography is the most reliable method for prenatal clubfoot diagnosis.
- Optimal timing for ultrasonographic diagnosis is between the 18th and 24th weeks of pregnancy.
- No consensus exists on fetal karyotyping for isolated clubfoot.
Conclusions:
- Ultrasonography is the gold standard for prenatal clubfoot detection.
- Early diagnosis necessitates careful pregnancy surveillance for additional anomalies.
- Invasive testing should be considered if other fetal abnormalities are identified.
Background:
Clubfoot is one of the most common congenital limb deformities. Prenatal diagnosis of the condition is essential as it can help treat the malformation as early as possible. We reviewed the recent available literature concerning the current methods for prenatal diagnosis of clubfoot.
Methods:
The following databases were searched from 1966 to 2015: PubMed, OVID, Cochrane, CINAHL, Google scholar and Embase.
Results:
Out of a total number of 197 retrieved articles, after abstract or title page evaluation, 158 articles not matching the inclusion criteria were excluded. The full text versions of the remaining 39 articles were obtained, and their reference lists screened, with the addition of another 5 full-text articles.
Conclusions:
Currently, ultrasonography is considered the most reliable method of prenatal diagnosis of clubfoot. Ultrasonographic diagnosis of clubfoot appears more likely between the 18th and the 24th week of pregnancy. Alternative imaging is not indicated. There is no agreement whether to propose foetal karyotyping when isolated clubfoot is diagnosed by prenatal ultrasonography. Early detection of clubfoot should prompt a careful surveillance during pregnancy in order to detect any possible additional abnormalities and, if any of these are detected, invasive testing should be offered.
