Association of isolated short femur in the mid‐trimester fetus with perinatal outcome

Abstract

Objectives

Midtrimester Isolated Short Femur Length as a Predictor of Adverse Pregnancy Outcome

“…A short FL is variably defined as <5th-10th percentile for gestational age [2,3,4,5,6,7,8,9,10,11,12,13,14,15,16]. It is associated with congenital anomalies [2,3], aneuploidy (mostly trisomy 21) [2,3,6,7,8], skeletal dysplasia [4,5 ]and adverse pregnancy outcome [2,3,9,10,11,12]. Specifically, in the absence of anatomical or chromosomal malformations, isolated short FL has been associated with intrauterine growth restriction (IUGR), being small for gestational age (SGA) [2,3,9,10,11,12,13,14,15]and preeclampsia [11,16].…”

“…It is associated with congenital anomalies [2,3], aneuploidy (mostly trisomy 21) [2,3,6,7,8], skeletal dysplasia [4,5 ]and adverse pregnancy outcome [2,3,9,10,11,12]. Specifically, in the absence of anatomical or chromosomal malformations, isolated short FL has been associated with intrauterine growth restriction (IUGR), being small for gestational age (SGA) [2,3,9,10,11,12,13,14,15]and preeclampsia [11,16]. Short FL may also be explained constitutionally by ethnic origin and due to inaccurate dating [17,18,19].…”

“…Although there is wide agreement as to the association of midtrimester isolated short FL with IUGR and SGA, there are limited and conflicting data concerning the association of such a finding with other placenta-related complications, such as hypertensive disorders, oligohydramnios, preterm delivery and neonatal outcome [10,11,12,16]. The exact etiology of these associations is also poorly defined and has been suggested to originate in the redistribution of the blood flow due to placental dysfunction, with fetal and maternal consequences of low birth weight (LBW) and possibly preeclampsia [20,21].…”

Isolated short femur alone in the mid-trimester fetus is not associated with increased risk of aneuploidy: a clinical study in eastern India

“…13 Studies have confirmed that fetuses of asian mothers have shorter femurs and those of black mothers have longer femurs compared with fetuses of white mothers. 14 However, these ethnic differences were not confirmed by the study of Weisz et al 8 , and it is possible that other factors, such as maternal and paternal height, are more important than ethnicity alone in influencing fetal femur length. 15,16 In summary, isolated short femur, when present as lone soft marker, does not increase the background risk of fetal aneuploidy.…”

“…6,7 Early-onset intrauterine growth retardation was defined when EFW or AC < 5 th centile at the mid-trimester ultrasound scan. 8 Finding an isolated short femur at the time of midtrimester scan poses a challenge to the clinician: is there any fetal aneuploidy or is it a part of skeletal dysplasia or is it a normal variation? 9 There are studies which have shown that short femur is associated with increased risk of subsequent intrauterine growth retardation in pregnancy and small for gestational age neonates.…”