title: Outcome of fetuses with antenatally diagnosed short femur.
abstract: OBJECTIVE
  To examine the outcome of fetuses diagnosed with short femur length at the time of the routine anomaly scan.
  
  
  METHODS
  This was a retrospective review of all pregnancies referred to a tertiary referral unit with fetal femur length below the 5(th) centile for gestation at 18-24 weeks of gestation. All patients had undergone pregnancy dating and assessment of the risk of chromosomal abnormalities by measurement of fetal nuchal translucency at 11 to 13 + 6 weeks.
  
  
  RESULTS
  Over 5 years, 129 cases were evaluated. Detailed ultrasound examination showed associated fetal abnormalities in 46 (36%) cases, and these were classified as non-isolated. In this group, skeletal dysplasias (n = 16), chromosomal abnormalities (n = 10) and genetic syndromes (n = 4) were the most common associations. In contrast, there were no cases of chromosomal abnormalities or skeletal dysplasia in the 83 (64%) isolated cases. Early severe intrauterine growth restriction (IUGR) with abnormal umbilical artery Doppler findings and delivery before 37 weeks occurred in 33/83 (40%) cases with isolated short femur, and 90% of these had abnormal uterine artery Doppler findings at the time of presentation. These pregnancies also had high rates of pre-eclampsia (36%) and intrauterine death (33%). Those with normal uterine artery Doppler imaging were at low risk for these complications.
  
  
  CONCLUSIONS
  In a population previously screened by first-trimester fetal nuchal translucency measurement, the finding of isolated short femur at 18-24 weeks is unlikely to be due to aneuploidy. Severe IUGR associated with high mortality occurs in 40%, making uterine artery Doppler evaluation a useful clinical tool.
authors.affiliation: Fetal Medicine Unit, Academic Department of Obstetrics and Gynaecology, St George's Hospital Medical School, London, UK. a.papageorghiou@sgul.ac.uk
authors.forename: A T
authors.initials: AT
authors.lastname: Papageorghiou
authors.forename: N
authors.initials: N
authors.lastname: Fratelli
authors.forename: K
authors.initials: K
authors.lastname: Leslie
authors.forename: A
authors.initials: A
authors.lastname: Bhide
authors.forename: B
authors.initials: B
authors.lastname: Thilaganathan
mesh_terms: D000782:Aneuploidy; D005260:Female; D005269:Femur / Q000002:abnormalities* / Q000000981:diagnostic imaging / Q000196:embryology; D006801:Humans; D007231:Infant, Newborn; D008297:Male; D011247:Pregnancy; D011256:Pregnancy Outcome; D011261:Pregnancy Trimester, First / Q000378:metabolism; D012189:Retrospective Studies; D016216:Ultrasonography, Prenatal / Q000379:methods