Congenital isolated clubfoot: Correlation between prenatal assessment and postnatal degree of severity
Objective Since prenatal diagnosis of isolated clubfoot has a false positive rate (FP) of 10%‐40%, fetal parameters that might correlate with post‐natal confirmation and grade of severity were investigated. Method Retrospective analysis (2013‐2019) of cases analysed with three‐dimensional multiplana...
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| Published in: | Prenatal diagnosis Vol. 40; no. 12; pp. 1547 - 1552 |
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| Main Authors: | , , , , , , , |
| Format: | Journal Article |
| Language: | English |
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Chichester, UK
John Wiley & Sons, Ltd
01-12-2020
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| Abstract | Objective
Since prenatal diagnosis of isolated clubfoot has a false positive rate (FP) of 10%‐40%, fetal parameters that might correlate with post‐natal confirmation and grade of severity were investigated.
Method
Retrospective analysis (2013‐2019) of cases analysed with three‐dimensional multiplanar view. The following data were recorded: the angle between the long axis of foot and lower leg; width, length and width‐to‐length ratio (W/L) of the foot; tibia length and calf width (T/C) ratio. Severity after birth was assessed using the Pirani classification.
Results
Diagnosis was confirmed in 45/53 neonates (84.9%, FP 15%). Values were higher for both angle and W/L in true vs false positive cases (median angle 100.4° versus 69.55°, p <.000; median W/L 0.53 vs 0.45, p = .001), no difference for T/C (3.77 vs 3.48, p = .8). The area under the curve for angle was 0.98 (CI 0.94‐1.00), with a diagnostic cut‐off of 84.7° (PPV of 100%, NPV of 66.7%). Median Pirani score, available for 33 neonates (73.3%) was 3 (IQR 3‐4): only angle correlated with Pirani score (Spearman coefficient 0.36, p = .04)
Conclusion
Measuring the angle between the foot and lower leg can reduce the FP rate of prenatal congenital clubfoot diagnosis and better predict the need for postnatal treatment. |
|---|---|
| AbstractList | Objective
Since prenatal diagnosis of isolated clubfoot has a false positive rate (FP) of 10%‐40%, fetal parameters that might correlate with post‐natal confirmation and grade of severity were investigated.
Method
Retrospective analysis (2013‐2019) of cases analysed with three‐dimensional multiplanar view. The following data were recorded: the angle between the long axis of foot and lower leg; width, length and width‐to‐length ratio (W/L) of the foot; tibia length and calf width (T/C) ratio. Severity after birth was assessed using the Pirani classification.
Results
Diagnosis was confirmed in 45/53 neonates (84.9%, FP 15%). Values were higher for both angle and W/L in true vs false positive cases (median angle 100.4° versus 69.55°, p <.000; median W/L 0.53 vs 0.45, p = .001), no difference for T/C (3.77 vs 3.48, p = .8). The area under the curve for angle was 0.98 (CI 0.94‐1.00), with a diagnostic cut‐off of 84.7° (PPV of 100%, NPV of 66.7%). Median Pirani score, available for 33 neonates (73.3%) was 3 (IQR 3‐4): only angle correlated with Pirani score (Spearman coefficient 0.36, p = .04)
Conclusion
Measuring the angle between the foot and lower leg can reduce the FP rate of prenatal congenital clubfoot diagnosis and better predict the need for postnatal treatment. Since prenatal diagnosis of isolated clubfoot has a false positive rate (FP) of 10%-40%, fetal parameters that might correlate with post-natal confirmation and grade of severity were investigated. Retrospective analysis (2013-2019) of cases analysed with three-dimensional multiplanar view. The following data were recorded: the angle between the long axis of foot and lower leg; width, length and width-to-length ratio (W/L) of the foot; tibia length and calf width (T/C) ratio. Severity after birth was assessed using the Pirani classification. Diagnosis was confirmed in 45/53 neonates (84.9%, FP 15%). Values were higher for both angle and W/L in true vs false positive cases (median angle 100.4° versus 69.55°, p <.000; median W/L 0.53 vs 0.45, p = .001), no difference for T/C (3.77 vs 3.48, p = .8). The area under the curve for angle was 0.98 (CI 0.94-1.00), with a diagnostic cut-off of 84.7° (PPV of 100%, NPV of 66.7%). Median Pirani score, available for 33 neonates (73.3%) was 3 (IQR 3-4): only angle correlated with Pirani score (Spearman coefficient 0.36, p = .04) CONCLUSION: Measuring the angle between the foot and lower leg can reduce the FP rate of prenatal congenital clubfoot diagnosis and better predict the need for postnatal treatment. OBJECTIVESince prenatal diagnosis of isolated clubfoot has a false positive rate (FP) of 10%-40%, fetal parameters that might correlate with post-natal confirmation and grade of severity were investigated. METHODRetrospective analysis (2013-2019) of cases analysed with three-dimensional multiplanar view. The following data were recorded: the angle between the long axis of foot and lower leg; width, length and width-to-length ratio (W/L) of the foot; tibia length and calf width (T/C) ratio. Severity after birth was assessed using the Pirani classification. RESULTSDiagnosis was confirmed in 45/53 neonates (84.9%, FP 15%). Values were higher for both angle and W/L in true vs false positive cases (median angle 100.4° versus 69.55°, p <.000; median W/L 0.53 vs 0.45, p = .001), no difference for T/C (3.77 vs 3.48, p = .8). The area under the curve for angle was 0.98 (CI 0.94-1.00), with a diagnostic cut-off of 84.7° (PPV of 100%, NPV of 66.7%). Median Pirani score, available for 33 neonates (73.3%) was 3 (IQR 3-4): only angle correlated with Pirani score (Spearman coefficient 0.36, p = .04) CONCLUSION: Measuring the angle between the foot and lower leg can reduce the FP rate of prenatal congenital clubfoot diagnosis and better predict the need for postnatal treatment. Abstract Objective Since prenatal diagnosis of isolated clubfoot has a false positive rate (FP) of 10%‐40%, fetal parameters that might correlate with post‐natal confirmation and grade of severity were investigated. Method Retrospective analysis (2013‐2019) of cases analysed with three‐dimensional multiplanar view. The following data were recorded: the angle between the long axis of foot and lower leg; width, length and width‐to‐length ratio (W/L) of the foot; tibia length and calf width (T/C) ratio. Severity after birth was assessed using the Pirani classification. Results Diagnosis was confirmed in 45/53 neonates (84.9%, FP 15%). Values were higher for both angle and W/L in true vs false positive cases (median angle 100.4° versus 69.55°, p <.000; median W/L 0.53 vs 0.45, p = .001), no difference for T/C (3.77 vs 3.48, p = .8). The area under the curve for angle was 0.98 (CI 0.94‐1.00), with a diagnostic cut‐off of 84.7° (PPV of 100%, NPV of 66.7%). Median Pirani score, available for 33 neonates (73.3%) was 3 (IQR 3‐4): only angle correlated with Pirani score (Spearman coefficient 0.36, p = .04) Conclusion Measuring the angle between the foot and lower leg can reduce the FP rate of prenatal congenital clubfoot diagnosis and better predict the need for postnatal treatment. ObjectiveSince prenatal diagnosis of isolated clubfoot has a false positive rate (FP) of 10%‐40%, fetal parameters that might correlate with post‐natal confirmation and grade of severity were investigated.MethodRetrospective analysis (2013‐2019) of cases analysed with three‐dimensional multiplanar view. The following data were recorded: the angle between the long axis of foot and lower leg; width, length and width‐to‐length ratio (W/L) of the foot; tibia length and calf width (T/C) ratio. Severity after birth was assessed using the Pirani classification.ResultsDiagnosis was confirmed in 45/53 neonates (84.9%, FP 15%). Values were higher for both angle and W/L in true vs false positive cases (median angle 100.4° versus 69.55°, p <.000; median W/L 0.53 vs 0.45, p = .001), no difference for T/C (3.77 vs 3.48, p = .8). The area under the curve for angle was 0.98 (CI 0.94‐1.00), with a diagnostic cut‐off of 84.7° (PPV of 100%, NPV of 66.7%). Median Pirani score, available for 33 neonates (73.3%) was 3 (IQR 3‐4): only angle correlated with Pirani score (Spearman coefficient 0.36, p = .04)ConclusionMeasuring the angle between the foot and lower leg can reduce the FP rate of prenatal congenital clubfoot diagnosis and better predict the need for postnatal treatment. |
| Author | Rustico, MariaAngela Cetin, Irene Monforte, Sergio Casati, Daniela Lanna, Mariano Torre, Clelia Andreacchio, Antonio Faiola, Stefano |
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| CitedBy_id | crossref_primary_10_1002_ped4_12334 crossref_primary_10_1016_j_ejogrb_2021_07_009 crossref_primary_10_3390_diagnostics14010117 crossref_primary_10_3390_diagnostics11122235 |
| Cites_doi | 10.1007/s00264-018-3873-3 10.1002/ajmg.a.35955 10.1002/uog.4079 10.1148/radiology.155.1.3883419 10.2106/00004623-196345020-00004 10.1002/jcu.22275 10.7863/jum.2012.31.7.997 10.1002/pd.5077 10.1016/j.ajog.2019.09.022 10.1542/peds.113.2.376 10.1002/uog.8932 10.1002/pd.4534 10.1002/uog.8831 10.1159/000354554 10.7863/jum.2008.27.5.701 10.1097/BPO.0000000000000182 10.1302/0301-620X.88B8.17482 |
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Since prenatal diagnosis of isolated clubfoot has a false positive rate (FP) of 10%‐40%, fetal parameters that might correlate with post‐natal... Since prenatal diagnosis of isolated clubfoot has a false positive rate (FP) of 10%-40%, fetal parameters that might correlate with post-natal confirmation and... Abstract Objective Since prenatal diagnosis of isolated clubfoot has a false positive rate (FP) of 10%‐40%, fetal parameters that might correlate with... ObjectiveSince prenatal diagnosis of isolated clubfoot has a false positive rate (FP) of 10%‐40%, fetal parameters that might correlate with post‐natal... OBJECTIVESince prenatal diagnosis of isolated clubfoot has a false positive rate (FP) of 10%-40%, fetal parameters that might correlate with post-natal... |
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| Title | Congenital isolated clubfoot: Correlation between prenatal assessment and postnatal degree of severity |
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