Diagnostic accuracy of isolated clubfoot in twin compared to singleton gestations
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Armin S. Razavi
,
Stephen T. Chasen
Abstract
Background
Our objective was to determine the predictive value of the prenatal diagnosis of isolated clubfoot in twin gestations compared to singleton gestations.
Methods
A prospectively entered ultrasound database was reviewed for all pregnancies scanned at our institution from 2002 to 2014. Cases of suspected clubfoot were identified. Neonates with associated anomalies or aneuploidy, and patients who delivered at other institutions were excluded. Neonatal charts were reviewed for the confirmation of clubfoot. The chi-squared (χ2) test, Fisher’s exact test and the Mann-Whitney U test were used in the analysis, with p < 0.05 considered significant.
Results
Of those women who had prenatal ultrasound and subsequently delivered at our hospital, 84 pregnancies had isolated clubfoot suspected in the antenatal period. Of these pregnancies, 20 were twin gestations and 64 were singleton gestations. Overall, 51/84 (60.7%) pregnancies had clubfoot confirmed during the neonatal period. Of the twin pregnancies, only 35% (7/20) had a confirmed diagnosis of clubfoot at birth compared to 68.8% (44/64) of the singleton pregnancies (P = 0.008). Gestational age at diagnosis, breech presentation, neonatal gender, unilateral vs. bilateral clubfoot and suspicion of clubfoot in the presenting twin (Twin A) vs. the non-presenting twin (Twin B) did not correlate with an accurate diagnosis of clubfoot in twins.
Conclusion
False-positive prenatal diagnosis of isolated clubfoot is more common in twin gestations compared to singletons. This may be due to transient malpositioning or a result of diminished space. Obstetric providers should consider the possibility of a false-positive diagnosis and use caution when counseling patients about a prenatal suspicion for clubfoot, especially in twin gestations.
Author contributions: All the authors have accepted responsibility for the entire content of this submitted manuscript and approved submission.
Research funding: None declared.
Employment or leadership: None declared.
Honorarium: None declared.
Competing interests: The funding organization(s) played no role in the study design; in the collection, analysis, and interpretation of data; in the writing of the report; or in the decision to submit the report for publication.
References
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Article note
This paper was presented at the 2016 ACOG Annual Clinical and Scientific Meeting in Washington, DC on May 14–17, 2016.
©2019 Walter de Gruyter GmbH, Berlin/Boston
Artikel in diesem Heft
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- Original Article – Newborn
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- Letters to the Editor
- Methodological issues on the clinical importance of the 75-g glucose tolerance test (GTT) in the prediction of large for gestational age (LGA) fetuses in non-diabetic pregnancies
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Artikel in diesem Heft
- Frontmatter
- Editorial
- Preterm premature rupture of membranes (PPROM)
- Original Articles – Obstetrics
- The value of amniotic fluid analysis in patients with suspected clinical chorioamnionitis
- Patients with acute cervical insufficiency without intra-amniotic infection/inflammation treated with cerclage have a good prognosis
- Maternal serum endocan concentrations are elevated in patients with preterm premature rupture of membranes
- The earlier the gestational age, the greater the intensity of the intra-amniotic inflammatory response in women with preterm premature rupture of membranes and amniotic fluid infection by Ureaplasma species
- Assessment of maternal GBS colonization and early-onset neonatal disease rate for term deliveries: a decade perspective
- Clinical importance of the 75-g glucose tolerance test (GTT) in the prediction of large for gestational age (LGA) fetuses in non-diabetic pregnancies
- Expression of genes involved in inflammation and growth – does sampling site in human full-term placenta matter?
- Impact of cell-free fetal DNA on invasive prenatal diagnostic tests in a real-world public setting
- Perinatal outcome in gestational diabetes according to different diagnostic criteria
- Original Articles – Fetus
- Change in fetal behavior in response to vibroacoustic stimulation
- Diagnostic accuracy of isolated clubfoot in twin compared to singleton gestations
- Original Article – Newborn
- Usefulness of transcutaneous bilirubin assessment measured in non-photo-exposed skin to guide the length of phototherapy: an observational study
- Letters to the Editor
- Methodological issues on the clinical importance of the 75-g glucose tolerance test (GTT) in the prediction of large for gestational age (LGA) fetuses in non-diabetic pregnancies
- Reply to the Letter to the Editor: methodological issues on the clinical importance of the 75-g glucose tolerance test (GTT) in the prediction of large-for-gestational-age (LGA) fetuses in non-diabetic pregnancies
