title: Isolated clubfoot diagnosed prenatally: is karyotyping indicated?
abstract: OBJECTIVE
  To evaluate the appropriateness of fetal karyotyping after prenatal sonographic diagnosis of isolated unilateral or bilateral clubfoot.
  
  
  METHODS
  We retrospectively reviewed a database of fetal abnormalities diagnosed by ultrasound at a single tertiary referral center from July 1994 to March 1999 for cases of unilateral or bilateral clubfoot. Fetuses who had additional anomalies diagnosed prenatally, after targeted sonographic fetal anatomy surveys, were excluded. Outcome results included fetal karyotype diagnosed by amniocentesis, or newborn physical examination by a pediatrician.
  
  
  RESULTS
  During the 5-year period, 5,731 fetal abnormalities were diagnosed from more than 27,000 targeted prenatal ultrasound examinations. There were 51 cases of isolated clubfoot. The mean maternal age at diagnosis was 30.5 years. The mean gestational age at diagnosis was 21.6 weeks. Twenty-three of the women (45%) were at increased risk of fetal aneuploidy, on the basis of advanced maternal age or abnormal maternal serum screening. Six women (12%) had positive family histories of clubfoot; however, no cases of aneuploidy were found by fetal karyotype evaluation or newborn physical examination. All cases of clubfoot diagnosed prenatally were confirmed at newborn physical examination, and no additional malformations were detected.
  
  
  CONCLUSIONS
  After prenatal diagnosis of isolated unilateral or bilateral clubfoot, there appeared to be no indication to offer karyotyping, provided that a detailed sonographic fetal anatomy survey was normal and there were no additional indications for invasive prenatal diagnoses.
authors.affiliation: Department of Obstetrics and Gynecology, Columbia University College of Physicians and Surgeons, Columbia-Presbyterian Medial Center, New York, New York 10032, USA. malonef@zeus.cpmc.columbia.edu
authors.forename: F D
authors.initials: FD
authors.lastname: Malone
authors.forename: T
authors.initials: T
authors.lastname: Marino
authors.forename: D W
authors.initials: DW
authors.lastname: Bianchi
authors.forename: K
authors.initials: K
authors.lastname: Johnston
authors.forename: M E
authors.initials: ME
authors.lastname: D'Alton
mesh_terms: D000328:Adult; D003025:Clubfoot / Q000000981:diagnostic imaging*; D005260:Female; D006801:Humans; D007621:Karyotyping; D008297:Male; D012189:Retrospective Studies; D016216:Ultrasonography, Prenatal