Risk of Adverse Outcomes in Euploid Pregnancies With Isolated Short Fetal Femur and Humerus on Second-Trimester Sonography

J Ultrasound Med. 2016 Dec;35(12):2675-2680. doi: 10.7863/ultra.16.01086.

Abstract

Objectives: The purpose of this study was to evaluate pregnancies with isolated short fetal femur and humerus on second-trimester sonography. Short fetal long bones are known to be associated with aneuploidy and structural anomalies. In this study, we wanted to show the risk of adverse pregnancy outcomes in euploid and nonanomalous pregnancies.

Methods: Singleton pregnancies with short femur and humerus were included. Pregnancies with normal fetal bone lengths and age-matched mothers were selected as controls.

Results: The study group included 30 pregnancies with short fetal femur and humerus, and the control group included 60 normal pregnancies. The overall odds ratio for an adverse pregnancy outcome in the study group was 24.9. Preterm delivery occurred significantly more frequently (odds ratio, 20.8; P < .001), and one-third of pregnancies were complicated by preeclampsia. In the group with short long bones, the odds ratio for a pathologic umbilical Doppler flow pattern was 45.2 (P < .001), and birth weight was significantly lower (P < .001). Also, 3 (10.3%) stillbirths and 4 (13.3%) cases of early neonatal death were recorded in this group. These complications were not recorded in the control group. The risk of emergency cesarean delivery was significantly higher in the group with short long bones (odds ratio, 11.8; P < .001).

Conclusions: The risk of adverse pregnancy outcomes is significant in euploid and nonanomalous pregnancies with isolated short long bones. Close follow-up is needed during pregnancy.

Keywords: fetal growth restriction; obstetric ultrasound; perinatal death; placental insufficiency; preeclampsia; pregnancy-associated plasma protein A; premature birth; short long bones; stillbirth.

MeSH terms

  • Adult
  • Female
  • Femur / abnormalities
  • Femur / diagnostic imaging*
  • Femur / embryology
  • Humans
  • Humerus / abnormalities
  • Humerus / diagnostic imaging*
  • Humerus / embryology
  • Pregnancy
  • Pregnancy Outcome*
  • Pregnancy Trimester, Second*
  • Retrospective Studies
  • Ultrasonography, Prenatal*