Accuracy of Prenatal Ultrasound Diagnosis of Isolated Clubfoot in Singletons Compared to Twins [5L]

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Abstract

INTRODUCTION:

Our objective was to determine the accuracy of prenatal diagnosis of clubfoot in twin compared to singleton gestations.

METHODS:

A prospectively entered ultrasound database was reviewed for all pregnancies scanned at our institution from 2002–2014. Cases of suspected clubfoot were identified. Neonates with associated anomalies or aneuploidy or patients who delivered at other institutions were excluded. Neonatal charts were reviewed for confirmation of clubfoot. Chi squared, Fisher exact and Mann-Whitney U tests were used in analysis with P less than .05 considered significant.

RESULTS:

Of 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. Of the twin gestations, clubfoot was suspected in the presenting twin in 13/20 cases (65%). 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=.008). Neonatal gender, gestational age at diagnosis and fetal presentation were not associated with accuracy of prenatal diagnosis.

CONCLUSION:

False-positive prenatal diagnosis of isolated clubfoot is more common in twin gestations compared to singletons. This may reflect a transient malpositioning or perhaps a reflection of diminished space, and requires caution when counseling patients in this setting.

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