Review of perinatal management of arthrogryposis at a large UK teaching hospital serving a multiethnic population.
OBJECTIVE
To review the prevalence and perinatal management of cases of arthrogryposis delivering at our hospital over a 6-year period.


METHODS
This was a retrospective review of cases of arthrogryposis managed at a UK teaching hospital. Cases were identified from the regional congenital anomalies register and departmental databases. Case notes were reviewed and analysed.


RESULTS
From 2002 to 2007, there were 27 cases of arthrogryposis. Sixteen (59.3%) were Caucasians, 7(25.9%) Asians and 4(14.8%) Afro-Caribbean; 17(63%) were nulliparous. In eight (29.6%) cases, there was a family history of congenital anomalies. Three had previously affected siblings and in three cases the parents were affected with arthrogryposis. Five (18.5%) were from consanguineous families. Eighteen (66.7%) cases were diagnosed prenatally at a mean gestational age of 21 weeks. Twelve (57%) were delivered by caesarean section. There were 18 live births. Sixteen (59%) cases were reviewed by clinical geneticist. Following detailed review and investigation including post-mortems, 20 (74%) of our cases had a formal diagnosis or likely cause identified.


CONCLUSIONS
Suspected cases of arthrogryposis require multi-disciplinary management to optimise the possibility of making a diagnosis and providing parents with accurate information to enable them to make informed choices regarding the pregnancy and providing information regarding likelihood of recurrence.
Navti
O B
OB
Department of Women's Perinatal and Sexual Health Services, University Hospitals of Leicester NHS Trust, Leicester Royal Infirmary, Infirmary Square, Leicester, UK. onavti@doctors.org.uk
Kinning
E
E
Vasudevan
P
P
Barrow
M
M
Porter
H
H
Howarth
E
E
Konje
J
J
Khare
M
M
D000293:Adolescent; D000328:Adult; D001176:Arthrogryposis / Q000175:diagnosis / Q000208:ethnology* / Q000628:therapy*; D044466:Asian People / Q000208:ethnology; D044383:Black People / Q000208:ethnology; D005006:Ethnicity; D005192:Family Health; D005260:Female; D005865:Gestational Age; D006784:Hospitals, Teaching; D006801:Humans; D007231:Infant, Newborn; D010375:Pedigree; D011247:Pregnancy; D011256:Pregnancy Outcome; D015995:Prevalence; D012189:Retrospective Studies; D016216:Ultrasonography, Prenatal; D006113:United Kingdom / Q000453:epidemiology; D044465:White People / Q000208:ethnology; D055815:Young Adult