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Updated: Jun 15, 2025
High Frequency Ultrasound for the Analysis of Fetal and Placental Development In Vivo
Published on: November 8, 2018
The Feasibility of Prenatal Ultrasonic Screening for Developmental Dysplasia of the Hip
Claudia Bevilacqua1, Virginia Boscarato2, Giovanni Pieroni3
1Adult and Pediatric Orthopedic Clinic, Azienda Ospedaliero-Universitaria Ospedali Riuniti di Ancona, Via Conca 71, 60126 Torrette, Italy.
Insights
Prenatal ultrasound can reliably assess infant hip development by the third trimester, correlating with postnatal findings. This may enable earlier identification of developmental dysplasia of the hip (DDH) risk.
Area of Science:
- Orthopedics
- Fetal Medicine
- Radiology
Background:
- Developmental dysplasia of the hip (DDH) is a common infant hip abnormality.
- Early diagnosis is crucial for effective treatment, preventing complex surgeries.
- Current postnatal screening methods lack universal consensus on efficacy.
Purpose of the Study:
- To investigate the feasibility of prenatal ultrasound for early detection of DDH risk.
- To assess the reliability of fetal hip ultrasound in quantifying hip joint parameters.
Main Methods:
- Prospective observational study of 100 pregnant women.
- Fetal hip ultrasounds performed in the second and third trimesters using the modified Graf method.
- Comparison of prenatal and postnatal alpha and beta angles.
Main Results:
- Third-trimester prenatal ultrasound (34 weeks) reliably determined fetal hip alpha and beta angles.
- Significant correlations observed between prenatal and postnatal hip measurements.
- Prenatal hip angles differed significantly between fetuses developing mature and immature hips postnatally.
Conclusions:
- Prenatal ultrasound shows potential for predicting infant hip development.
- Further research is needed to confirm the clinical utility and strength of correlation for prenatal DDH risk assessment.
Background:
developmental dysplasia of the hip (DDH) is a condition characterized by abnormal hip development in infancy. Early diagnosis allows for effective treatment, while late presentation often necessitates complex surgical interventions. Current recommendations advise screening between the 6th and 8th week postnatal using an ultrasound, typically employing the Graf method. However, there is no universal consensus on whether ultrasound screening significantly increases treatment likelihood compared to clinical examination-guided ultrasound. This study aims to explore the feasibility of prenatal ultrasound for the early identification of DDH risk.
Methods:
This prospective observational study involved 100 pregnant women undergoing fetal hip ultrasounds during the second and third trimesters. Using the modified Graf method, alpha and beta angles were calculated on the fetus. Postnatally, alpha and beta angles were compared with the prenatal values.
Results:
Prenatal ultrasound at the 24th week showed inconclusive results because of the difficulty in identification of Graf landmarks, while ultrasound at the 34th week proved to be a reliable and safe method for the quantitative determination of alpha and beta angles. Significant correlations were found between prenatal and postnatal alpha and beta angles. Moreover, significant differences in prenatal alpha and beta values were observed in patients developing mature/immature hips postnatally.
Conclusions:
Prenatal diagnostics show promise for predicting infant hip development. Further research is warranted to validate correlation strength and clinical applicability.
