Outcome in prenatal diagnosis of isolated or complex clubfoot – systematic review and case series

Abstract

Clubfoot represents a congenital limb deformity, with a frequency of 1/1000 pregnancies, and it is one of the most common musculoskeletal deformities presenting at birth. Although it is diagnosed at birth, many cases are detected from the antenatal period, following an ultrasound examination. In about half of the cases, both feet are affected, boys being twice more likely than girls to have the deformity. Objective. This study aims to review the literature regarding the outcome of isolated clubfoot and the risk that stems from its association with other anomalies. Materials and method. The online database was used to detect studies that have evaluated the outcome of isolated clubfoot or associated with other abnormalities. The information from literature was compared with our experience at the Antenatal Diagnostic Unit from the Emergency County Clinical Hospital of Craiova, based on the ultrasound assessments performed during 2018. Results. If the malformation is isolated, it will have a good prognosis. It may be postural, especially in pelvic presentations associated with a reduced amniotic fluid. In complex clubfoot cases, associated with other structural abnormalities, a chromosomal abnormality may be diagnosed, or the cause may be neurological or muscular, and it is part of a syndrome. Conclusions. Because of the significant different prognosis, it is important to carry out an antenatal ultrasound diagnosis, as complex as possible, to discriminate between the presence of an isolated clubfoot from the cases where this abnormality is associated with other malformations.