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Outcome of antenatally diagnosed talipes equinovarus in an unselected obstetric population
Author(s) -
Bakalis S.,
Sairam S.,
Homfray T.,
Harrington K.,
Nicolaides K.,
Thilaganathan B.
Publication year - 2002
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 - 10.1046/j.1469-0705.2002.00780.x
Subject(s) - medicine , odds ratio , gestation , incidence (geometry) , confidence interval , obstetrics , retrospective cohort study , etiology , congenital talipes equinovarus , population , pregnancy , pediatrics , surgery , clubfoot , deformity , genetics , physics , environmental health , optics , biology
Objective To investigate the natural history and outcome of fetal talipes diagnosed by routine ultrasound scanning at 18–23 weeks' gestation. Patients and methods This was a retrospective study of 103 228 pregnancies undergoing routine ultrasound scanning at 18–23 weeks' gestation. A computer search was made to identify all cases of fetal talipes and the records of these patients were examined to determine the incidence of other defects and pregnancy outcome. Results The incidence of fetal talipes following routine ultrasound examination was 0.10% (107/103 228) and was bilateral in 64 (59.8%) and unilateral in 43 (40.2%) cases. In 52 (48.6%) cases, talipes was of complex etiology, as it was associated with other defects, while, in 55 (51.4%) cases, it was classified as idiopathic. In 19% of cases, an initial diagnosis of idiopathic talipes was changed to complex, because of the subsequent development of associated features. Perinatal death and long‐term neurodevelopmental or musculoskeletal problems were significantly more common when the talipes was complex rather than idiopathic (odds ratio, 150; 95% confidence interval, 34–665). Adverse outcomes were also seen more frequently with bilateral compared to unilateral talipes (odds ratio, 3.44; 95% confidence interval, 1.50–7.90). Conclusion The outcome of antenatally detected talipes is mainly dependent on the presence or absence of other defects. A significant proportion of cases, thought to be idiopathic at presentation, will develop associated complex features when reassessed on subsequent scans or postnatally. Copyright © 2002 International Society of Ultrasound in Obstetrics and Gynecology