The significance of ultrasonographically diagnosed fetal wrist position anomalies.

Abstract

Our purpose was to determine the clinical significance of ultrasonographically diagnosed fetal wrist position anomalies. The relationship of the fetal hand to the forearm was prospectively evaluated in all second- and third-trimester scans over a 5-year period. If an abnormal wrist position was detected, a targeted scan, including echocardiography, was performed. The outcomes of abnormal pregnancies were obtained. An abnormal relationship of the hand to the forearm was found in 22 fetuses in 27,467 scans. Nine had a normal karyotype, and 13 had an abnormal karyotype. Among the nine with normal chromosomes, three had evidence of a movement disorder. Three with normal karyotypes are alive; two of these are the only normally functioning survivors. They had no other major anomalies and were shown prenatally to have normal movement of the limbs. An abnormal fetal wrist position is associated with a high incidence of karyotype and movement abnormalities.