Prenatal Diagnosis of Clubfoot: Where Are We Now? Systematic Review and Meta-Analysis

Abstract

The primary methods for prenatal diagnosis of Clubfoot are ultrasound (US) and magnetic resonance imaging (MRI). An ultrasound is performed between the 1st trimester and the 28th week of pregnancy and it is reported to be used as a diagnostic method alone or in combination with MRI. So far, an international consensus on the most effective screening method has not been reached. This systematic review and meta-analysis were performed to establish the most effective and reliable exam for prenatal diagnosis of Clubfoot. The literature search was conducted using a PIOS-approach from May 2021 to June 2021. Studies reporting cases of prenatal diagnosis of Clubfoot made through US and MRI conducted from January 2010 to June 2021 were included in the study and reviewed by 2 authors. The 23 selected studies included 2318 patients. A total of 11 of the studies included details on the accuracy, while the rest were used to obtain information about the primary methodology utilized. In all the selected studies, US was used as the primary diagnostic instrument. Thirteen of the studies used the US exclusively, while three used MRI in addition to US and seven performed karyotyping after US diagnosis. The US has been shown to be the instrument of choice for the prenatal diagnosis of Clubfoot. International guidelines for an ultrasonography classification of congenital clubfoot are required to reduce the inter-variability accuracy of this procedure.

Ankle and Foot Deformities in Children

“…This deformity can be detected during prenatal ultrasonography (US), most commonly at the routine 20-week examination. 20…”

“…19 This deformity can be detected during prenatal ultrasonography (US), most commonly at the routine 20-week examination. 20 Clubfoot is clinically characterized by equinus and varus of the hindfoot, cavus of the midfoot, adductus of the forefoot, and atrophy of the posterior compartment of the leg. 16 There is a primary talonavicular malalignment due to medial subluxation of the navicular bone over the head of the talus, in which the long axis of the talus is directed laterally.…”

Clubfoot from past to the present: A bibliometric analysis with global productivity and research trends

“…Clubfoot, also known as talipes equinovarus , is a structural deformity of the foot and ankle with the hindfoot equinus (plantar flexion), varus of the heel (internal rotation), supination, and adduction of the forefoot (plantar cavus) developing early in pregnancy. [ 1 , 2 ] The deformity is classified into 3 different types: idiopathic (unknown cause), neurogenic (caused by nervous system status), and syndromic (related to an underlying syndrome). [ 3 ] The severity of the deformity can range from mild to manipulation-resistant extremely rigid foot.…”

Prenatal Diagnosis of Talipes Equinovarus by Ultrasound and Chromosomal Microarray Analysis: A Chinese Single-Center Retrospective Study

“…Its incidence is about 1–3 in 1000 of live births, and the proportion of male to female fetuses affected is about 2:1 [ 2 ]. TE includes four elements: metatarsus adductus, cavus foot, heel varus, and equinus, which is detected antenatally in over half of these cases by fetal ultrasound [ 3 ]. It can be unilateral (30–40%) or bilateral (60–70%) and can be either an isolated deformity (50–70%) or a manifestation of chromosomal abnormalities and other genetic syndromes (30–50%) [ 4 ].…”