Perinatal outcomes after sonographic detection of isolated short femur in the second trimester

Abstract

Isolated short femur in the second-trimester US examination is associated with a subsequent delivery of SGA and LBW neonates.

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

“…In our study group, 21% of the women gave birth to an SGA baby, similar to reports from other investigators, who have documented a prevalence of 19-43% [2,3,9,10,11,12]. Weisz et al[11], with a similar cutoff of short FL <5th percentile for gestational age, also reported an increased risk of SGA (OR 3, 95% CI 1.5-5.9).…”

“…Our finding of a correlation between short FL and severe preeclampsia is not supported by some trials [10,11,12] but has previously been reported in a few smaller trials [11,16]. Zalel et al [16] observed that in 7 of 9 patients with a short FL, gestational hypertension developed later on during the pregnancy.…”

“…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].…”

“…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].…”

“…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].…”