Perinatal outcomes of infants with congenital limb malformations: an observational study from a tertiary referral center in Central Europe

Farr, Alex; Wachutka, Eva; Bettelheim, Dieter; Windsperger, Karin; Farr, Sebastian

doi:10.1186/s12884-020-2720-x

Cited by 7 publications

(7 citation statements)

References 22 publications

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“…The final studies selected by the reviewers included the following levels of evidence: 19 level III retrospective studies [ 1 , 2 , 7 , 9 , 10 , 12 , 13 , 14 , 15 , 16 , 17 , 18 , 21 , 22 , 25 , 26 , 27 ], 3 level II prospective comparative studies [ 8 , 11 , 20 ], 1 descriptive study of level III [ 19 ] ( Table 1 ).…”

Section: Resultsmentioning

confidence: 99%

“…A total of 13 of the studies specified the timing at which the diagnosis was made [ 7 , 8 , 13 , 16 , 18 , 21 , 22 , 23 , 24 , 25 , 26 , 27 ]. Of the 13 studies that specified timing of diagnosis, 5 included diagnosis during trimester 1 [ 8 , 18 , 23 , 25 , 26 ], and this was the minimum age of diagnosis reported.…”

Section: Resultsmentioning

confidence: 99%

“…In all of the selected studies US was used as the primary diagnostic instrument. Thirteen of the studies [ 1 , 7 , 8 , 10 , 11 , 12 , 15 , 16 , 17 , 19 , 21 , 23 , 26 ] used the US exclusively, while in the rest of the studies [ 2 , 9 , 13 , 14 , 18 , 20 , 22 , 24 , 25 , 27 ] US was used in combination with other procedures such as MRI [ 2 , 9 , 20 ] or karyotyping [ 13 , 14 , 18 , 22 , 24 , 25 , 27 ] ( Table 1 ). Based on the data available and on the studies in which this item was present, the accuracy of this test averaged 80.9%.…”

Section: Resultsmentioning

confidence: 99%

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

et al. 2021

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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.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

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

et al. 2021

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“…The present study introduces an innovative typology of branch distribution of the superior gluteal nerve, implementing a comprehensive mathematical analysis of the obtained results. These results are of great cognitive importance and can also be used in future research in connection with the dynamically growing specialities of neonatal and intrauterine surgery [51,52].…”

Section: Plos Onementioning

confidence: 86%

The morphometrical and topographical evaluation of the superior gluteal nerve in the prenatal period

et al. 2022

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Introduction Advances in medical science are helping to break down the barriers to surgery. In the near future, neonatal or in utero operations will become the standard for the treatment of defects in the human motor system. In order to carry out such procedures properly, detailed knowledge of fetal anatomy is necessary. It must be presented in an attractive way not only for anatomists but also for potential clinicians who will use this knowledge in contact with young patients. This work responds to this demand and presents the anatomy of the superior gluteal nerve in human fetuses in an innovative way. The aim of this work is to determine the topography and morphometry of the superior gluteal nerve in the prenatal period. We chose the superior gluteal nerve as the object of our study because of its clinical significance—for the practice of planning and carrying out hip surgery and when performing intramuscular injections. Material and methods The study was carried out on 40 human fetuses (20 females and 20 males) aged from 15 to 29 weeks (total body length v-pl from 130 to 345 mm). Following methods were used: anthropological, preparatory, image acquisition with a digital camera, computer measurement system Scion for Windows 4.0.3.2 Alpha and Image J (accuracy up to 0.01 mm without damaging the unique fetal material) and statistical methods. Results The superior gluteal nerve innervates three physiologically significant muscles of the lower limb’s girdle: gluteus medius muscle, gluteus minimus muscle and tensor fasciae latae muscle. In this study the width of the main trunk of the nerve supplying each of these three muscles was measured and the position of the nerve after leaving the suprapiriform foramen was observed. A unique typology of the distribution of branches of the examined nerve has been created. The bushy and tree forms were distinguished. There was no correlation between the occurrence of tree and bushy forms with the body side (p > 0.05), but it was shown that the frequency of the occurrence of the bushy form in male fetuses is significantly higher than in female fetuses (p < 0.01). Proportional and symmetrical nerve growth dynamics were confirmed and no statistically significant sexual dimorphism was demonstrated (p > 0.05). Conclusions The anatomy of the superior gluteal nerve during prenatal period has been determined. We have identified two morphological forms of it. We have observed no differences between right and left superior gluteal nerve and no sexual dimorphism. The demonstrated high variability of terminal branches of the examined nerve indicates the risk of neurological complications in the case of too deep intramuscular injections and limits the range of potential surgical interventions in the gluteal region. The above research may be of practical importance, for example for hip surgery.

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“…It is also known that associated congenital malformations and chromosomal abnormalities are risk factors for prematurity [ 24 , 25 ], so the lack of antenatal diagnosis and therapeutic abortion for these serious abnormalities led to an increase in the frequency of premature births in our group. We demonstrated that prematurity increases the risk of death by 3.29 times in the case of patients with omphalocele (by 3.62 times in the regression model).…”

Section: Discussionmentioning

confidence: 99%

Current Challenges in the Treatment of the Omphalocele—Experience of a Tertiary Center from Romania

Ţarcă

Cojocaru

Trandafir

et al. 2022

JCM

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Omphalocele is a congenital abdominal wall defect with a constant incidence in recent decades, sometimes representing a real burden for neonatal intensive care units due to prolonged hospitalization and the evolution to death. In our study, we aimed to detect the main risk factors of an unfavorable evolution in the case of omphalocele. Methods: Retrospective cohort study of all neonates with omphalocele treated in our tertiary pediatric hospital during the last three decades; from 158 patients, 139 patients were eligible for the study. We tried to determine the risk of death using logistic regression model. Results: If the neonate develops sepsis, then there is an increased risk (13.03 times) of evolution to death. Similarly, the risk of death is 10.82 times higher in the case of developing acute renal failure, 6.28 times higher in the case of associated abnormalities, 5.54 in the case of developing hemorrhagic disease, and 3.78 in the case of conservative treatment (applied for giant omphalocele or severe chromosomal abnormalities). Prematurity increases by 3.62 times the risk of death. All six independent variables contributed 61.0% to the risk of death. The area under the ROC curve is 0.91, meaning that the diagnostic accuracy of our logistic regression model is very good for predicting the contribution of the six independent variables to the risk of death. Conclusion: Although in the past 30 years we witnessed several improvements in the antenatal diagnosis and management of omphalocele, survival rate remained constant, 47.5% overall. Much effort is still needed to eliminate the risk factors for death in this condition.

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Perinatal outcomes of infants with congenital limb malformations: an observational study from a tertiary referral center in Central Europe

Cited by 7 publications

References 22 publications

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

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

The morphometrical and topographical evaluation of the superior gluteal nerve in the prenatal period

Current Challenges in the Treatment of the Omphalocele—Experience of a Tertiary Center from Romania

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