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P06.05: Association of isolated short femur detected in the second trimester scan with adverse perinatal outcome
Author(s) -
Echevarria M.,
Caner N.,
Perdomo L.,
García S.,
Rodríguez I.,
Albaiges G.
Publication year - 2019
Publication title -
ultrasound in obstetrics and gynecology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.202
H-Index - 141
eISSN - 1469-0705
pISSN - 0960-7692
DOI - 10.1002/uog.20925
Subject(s) - medicine , femur , obstetrics , pregnancy , small for gestational age , gestational age , apgar score , birth weight , percentile , fetus , retrospective cohort study , caesarean section , pediatrics , surgery , genetics , biology , statistics , mathematics
Objectives: To evaluate the association between isolated short femur and adverse perinatal outcome. Methods: Retrospective study of 23,423 singleton pregnancies with a 19-22 scan over the period of 2007-2018. All patients had undergone pregnancy dating in our institution and screening for chromosomal abnormalities. Short femur was defined as a femur length below the 5th percentile according to Snijders et al reference. Aneuploidy and skeletal dysplasia were excluded. Primary outcome was the risk of small for gestational age (SGA) defined as birth weight less than the 5th percentile. Adverse perinatal outcome included the risk of Caesarean section for Abnormal trace, stillbirth, 5 min Apgar score < 7 and pHa < 7.1. Results: We found 638 isolated fetal femur < 5th percentile (2.7%). In pregnancies with isolated short femur there were higher rates of SGA (19.3% vs 6.7% p < 0,001). The positive predictive value of a short femur regarding SGA is 19.2% OR 3.31(2.70-4.06). The prevalence of adverse perinatal outcome (17,7% vs 9,7% p < 0,001) compared with controls was also significant with an OR 2.0 (1.63-2.47). Conclusions: Isolated short femur detected in the second trimester scan is associated with low birth weight and adverse perinatal outcome, we should incorporate this finding in the counselling. One out of five patients with short femur will have a SGA fetus.