Prenatal Detection of Clubfoot

Posted On: April 27, 2016 By Nathan D. Fox, MD

Clubfoot refers to a deformity in which an infant’s foot is turned inward, which may be so severe that the bottom of the foot is sideways or upward. According to the American Academy of Orthopaedic Surgeons, approximately one infant in every 1,000 live births will have clubfoot, which makes it one of the common congenital deformities present at birth.

Prenatal Detection of Clubfoot

Prenatal detection has improved significantly in the past ten years, increasing from 25 to almost 80 percent of cases. There have been false-positive rates as high as 40 percent reported for diagnosis of isolated clubfoot (meaning it is suspected on ultrasound, but the newborn does not have it), so any diagnosis during pregnancy would more accurately be described as “suspected clubfoot”.  These false positives are typically due to the ability of a healthy fetus to move its normal foot inward to the body.

Other associated abnormalities are seen in approximately 10 percent of live born babies with clubfoot; in these cases, it often is part of a syndrome. These abnormalities are more common with bilateral clubfoot than unilateral clubfoot. Fortunately, most cases of clubfoot are isolated and not associated with any syndrome.

We generally recommend amniocentesis and analysis of the fetal karyotype if there are additional anatomic abnormalities seen on ultrasound. A fetal echocardiogram can also be performed to look for associated cardiac abnormalities in the setting of suspected clubfoot.

In most cases of isolated clubfeet, there is an excellent postnatal prognosis thanks to the effective and safe treatments available. If a woman finds out her fetus has suspected clubfoot, she may choose to consult with a pediatric orthopedist with an expertise in treating clubfeet before delivery.

Carnegie Imaging for Women blogs are intended for educational purposes only and do not replace certified professional care. Medical conditions vary and change frequently. Please ask your doctor any questions you may have regarding your condition to receive a proper diagnosis or risk analysis. Thank you!

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