Prenatal Ultrasound for Diagnosis of Orthopaedic Conditions

Mahan, Susan T.; Kasser, James R.

doi:10.1097/bpo.0b013e3181c9ba1d

Cited by 4 publications

(5 citation statements)

References 41 publications

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“…Because the suspicion of clubfoot can cause substantial parental anxiety, parents who are given information about the possible diagnosis prenatally 2 often have access to prenatal counselling regarding the nature of the diagnosis and treatment options which they appreciate. 3 Some families choose to pursue prenatal counselling while others choose to pursue their own method of obtaining information, such as the internet or discussion with other providers or acquaintances. There also are some families who do not discover the foot anomaly until birth.…”

Section: Discussionmentioning

confidence: 99%

“…For those that are found prenatally, the option for prenatal counselling with a paediatric orthopaedic surgeon who specializes in childhood foot disorders may be offered. 3,4 Some choose to pursue this and others decline. The benefits of this prenatal counselling are difficult to measure and are typically related to parental anxiety about the diagnosis and treatment, however, it has been challenging to measure this impact.…”

Section: Introductionmentioning

confidence: 99%

“…1,4,8 When a foetus is found with a foot in the clubfoot position, many advocate for prenatal counselling. 3,4,9,10…”

Section: Introductionmentioning

confidence: 99%

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Prospective evaluation of parental anxiety related to newborn foot disorder

Mahan

Miller

May

et al. 2019

Journal of Children's Orthopaedics

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PurposeThe presence of a clubfoot is often found prenatally and some families seek counselling with a specialist. The purpose of this study was to compare the parental anxiety levels in families that: a) knew prenatally and had prenatal counselling; b) knew prenatally but did not seek prenatal counselling; and c) did not know until after delivery.MethodsThis prospective cohort study evaluated the anxiety of parents as they presented to the paediatric orthopaedic clinic with their newborn with a foot disorder (prior to the diagnostic confirmation of clubfoot). Each family filled out the ‘Pre-visit orthopaedic surgeon questionnaire’ and then after the initial visit with the orthopaedic surgeon (confirming the clubfoot diagnosis) the family filled out the ‘Immediately post-visit orthopaedic surgeon questionnaire’. Through these questionnaires, anxiety level was assessed prior to meeting postnatally with the paediatric orthopaedic specialist, as well as after the meeting and compared across groups.ResultsA total of 121 parents completed questionnaires: 71% (86/121) confirmed clubfoot; 69% of families (59/86) received prenatal counselling (Group A); 16% (14/86) knew prenatally but had no counselling (Group B); and 15% (13/86) found out at birth (Group C). There was no difference in anxiety levels across groups before (p = 0.78) or after (p = 0.57) meeting with the paediatric orthopaedic surgeon; however, overall anxiety reduced significantly (p < 0.001).ConclusionWe found no difference in the anxiety levels of across the three groups. Prenatal counselling for parents of children with likely clubfoot may not decrease parental anxiety, but nonetheless is very appreciated by the families who receive it.Level of EvidencePrognostic Level II

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Prospective evaluation of parental anxiety related to newborn foot disorder

Mahan

Miller

May

et al. 2019

Journal of Children's Orthopaedics

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“…The ability to detect clubfoot prenatally is of great importance as it offers the opportunity for families to educate themselves on treatment and prognosis of clubfoot. Families expecting a child known likely to have a clubfoot may pursue formal counseling with someone who specializes in clubfoot treatment or may pursue education in less formal venues. In fact, one study found that clubfoot informational talks with mothers moderated some of the negative thoughts and behaviors that harmed the mother–child bonding .…”

Section: Discussionmentioning

confidence: 99%

“…Prenatal diagnosis of clubfoot can be very beneficial for family education and counseling . It has been shown that expecting mothers want to know about the possible diagnosis of clubfoot prior to delivery and that bonding with a newborn with clubfoot may be impaired because of the foot deformity .…”

Section: Introductionmentioning

confidence: 99%

Prenatal screening for clubfoot: what factors predict prenatal detection?

et al. 2014

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Objective Routine prenatal ultrasound has often resulted in the early detection of musculoskeletal disorders. The purpose of this study was to determine which socioeconomic factors are associated with prenatal detection of clubfoot. Methods The Slone Epidemiology Center at Boston University identified infants in three states (MA, NY, NC) who were reported as having a clubfoot. Mothers of these children were contacted, interviewed, and medical records obtained. Data were analyzed by using logistic regression to estimate odds ratios (ORs) and 95% confidence intervals (CIs). Results Overall detection of the clubfoot prenatally was 62.3% (421/676) but this varied considerably by state: 81.1% in Massachusetts (154/190), 58.5% in New York (124/212), and 52.2% in North Carolina (143/274). Multivariate analysis revealed the strongest predictors for prenatal detection were maternal age ≥ 35 years (OR: 3.54), non-Hispanic black race (OR: 0.49), the presence of another birth defect (OR: 2.61), residing in Massachusetts (OR: 2.64) and the presence of a bilateral clubfoot (OR: 1.90). Conclusions We found a statistically significantly increase higher rate of prenatal detection of clubfoot in Massachusetts and decrease lower rate in younger mothers (age<35) and black mothers, even after adjustment for other sociodemographic variables.

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Prospective Evaluation of a Prenatal Sonographic Clubfoot Classification System

et al. 2013

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Background: The purpose of this study was to prospectively evaluate our recently described fetal sonographic classification system for prenatal diagnosis of clubfoot. Methods: Over 18 months, we prospectively enrolled consecutive pregnant patients evaluated for a prenatally diagnosed clubfoot. Prenatal sonographic scores assigned by a radiologist were compared to final clinical diagnosis and severity given by a pediatric orthopedic surgeon. Pearson's χ² test and logistic regression were used in statistical analyses on the subject level. Generalized estimating equations were used in analyses on the foot level to account for intrasubject correlation. Results: There were 50 subjects, with 26 unilateral and 24 bilateral clubfeet, according to the prenatal ultrasound (US). A total of 51 (69%) of 74 feet and 36 (72%) of 50 subjects had a postnatal diagnosis of clubfoot. The accuracy of diagnosis in cases of a severe, moderate, and mild US score was 94, 70, and 25%, respectively (p = 0.003 comparing moderate-severe vs. mild). US severity correlated with the Dimeglio classification scoring system (Spearman's correlation 0.30). Conclusion: The fetal sonographic scoring system is predictive of clinical severity after birth, and improves the ability to counsel families with a prenatal diagnosis of clubfoot.

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Prenatal Ultrasound for Diagnosis of Orthopaedic Conditions

Cited by 4 publications

References 41 publications

Prospective evaluation of parental anxiety related to newborn foot disorder

Prospective evaluation of parental anxiety related to newborn foot disorder

Prenatal screening for clubfoot: what factors predict prenatal detection?

Prospective Evaluation of a Prenatal Sonographic Clubfoot Classification System

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