clubfoot via ultrasound question

[Guest guest]

A girl that I have been speaking to who lives in the next town over from

mine was told that the child she is carrying has clubfoot. She isn't due

until March. Yesterday, she told me that when she had another ultrasound

they said it was definitely clubfoot but it wasn't that bad. Can the level

of severity be told through ultrasound? Is there a such thing as telling

how bad it is or is it that you either have clubfoot or you don't?

Obviously, I am aware of atypical clubfoot but that is not diagnosed until

after birth correct?

Mommy to (12-17-98) and

Christian (1-30-04) LCF - DBB 23/7

[Guest guest]

We found out through ultra sound and we were told they could not tell the

severity of it until it was born. They looked for other 'things' and decided

the c/f was an 'isolated anomoly' which in fact it was. We were shown the

pictures of his feet from the scan and they pretty much looked like that

when he came out!! All a thing of the past now!!

Rach

-- clubfoot via ultrasound question

A girl that I have been speaking to who lives in the next town over from

mine was told that the child she is carrying has clubfoot. She isn't due

until March. Yesterday, she told me that when she had another ultrasound

they said it was definitely clubfoot but it wasn't that bad. Can the level

of severity be told through ultrasound? Is there a such thing as telling

how bad it is or is it that you either have clubfoot or you don't?

Obviously, I am aware of atypical clubfoot but that is not diagnosed until

after birth correct?

Mommy to (12-17-98) and

Christian (1-30-04) LCF - DBB 23/7

[Guest guest]

When Kelsey's was diagnosed during ultrasound they told me that it did

not look severe but that there as no way of really telling until she was

born so I think it may just be a guess, at least from the perspective of

the specialist that we saw.

Jenni

Gerace wrote:

>A girl that I have been speaking to who lives in the next town over from

>mine was told that the child she is carrying has clubfoot. She isn't due

>until March. Yesterday, she told me that when she had another ultrasound

>they said it was definitely clubfoot but it wasn't that bad. Can the level

>of severity be told through ultrasound? Is there a such thing as telling

>how bad it is or is it that you either have clubfoot or you don't?

>Obviously, I am aware of atypical clubfoot but that is not diagnosed until

>after birth correct?

>

>

>

>

>

>Mommy to (12-17-98) and

>

>Christian (1-30-04) LCF - DBB 23/7

>

>

>

>

>

>

[Guest guest]

,

Here is some information on ultrasounds and when clubfoot

developes from different sources.

A number of parents on different internet groups have had their

childs clubfoot identified on a prenatal ultrasound.

In Dr. Ponseti's 1996 book on page 50, he says, " Present day

sonography applied to the study of fetal development in utero has

opened a new dimension in this field. Under sonography, we and

others ... have observed that an apparently normal foot of an 11-

week-

old fetus turns into a clubfoot at 14 weeks within a uterine cavity

filled with abundant amniotic fluid. The congenital clubfoot,

therefore, seems to be a developmental anomaly originating after the

third month of intrauterine life and not an embryonic malformation. "

Other information from Dr. Ponseti on when clubfoot begins to

develope can be seen in his 2001 article on treating relapses.

" The clubfoot in otherwise normal children is a developmental anomaly

originating after the third month of intrauterine life. It is induced

by an unknown dysfunction in the posterior and medial aspects of the

lower leg, ankle and foot ... "

" The period of dysfunction causing the deformity starting in the

middle third of pregnancy lasts to the third or fourth year of life.

In mild cases, it may start in late fetal life, and remain active for

only a few months after birth. In all cases, the resulting fibrosis

is most pronounced from a few weeks preceding birth, to a few months

after birth. This is the period when collagen accretion is greatest

in tendons and ligaments of normal mammals and presumably also of

man. The speed of growth of the foot decreases after the first year

of life, diminishing greatly after five years. "

http://groups.yahoo.com/group/nosurgery4clubfoot/message/13223

At the 3rd International Congress on Clubfoot in San Diego last

August 2002, Dr. Henri Bensahel of Paris, France presented a study

they

had done on 5,000 ultrasounds since 1998. Their studies results said

that clubfoot by ultrasound " is easier (to identify) when the

investigation is made around the 20th week of pregnancy. By that

time, the talipes equinovarus can be well screened. The calf is less

developed than usual and the comparison is easier if the clubfoot is

unilateral. The diagnosis is also suspected by looking at the shape

of the foot and it's ability to move. However, the confirmation of

(it being a) true clubfoot is made (at) the time of the physical exam

at birth ... In our study, the prenatal diagnosis of clubfoot could

be made from the 12th week to the 34th week of pregnancy. "

" Thanks to the ultrasound investigation during pregnancy, we can

evaluate the type of deformity of the foot although we are not able

to (determine) the degree of severity. The severity is not related

to the time of the prenatal diagnosis. "

A poll on that ultrasound question at the Ponseti site had 22

responses with these results.

Diagnosed during 2nd trimester - 8 or 36%

Diagnosed during 3rd trimester - 0

Diagnosed after birth - 14 - 63%

http://groups.yahoo.com/group/nosurgery4clubfoot/surveys?id=59565

At our own ultrasound, it was not brought up, but later the U of Iowa

doctors looked at our ultrasound snapshot picture and were able to

identify that the clubfoot was there and had been missed.

Clubfoot can be seen in ultrasounds, but it can't really be

determined for sure if it is a real clubfoot until after the baby is

born and is examined. Some children have what is called postional

clubfoot which may look like clubfoot on an ultrasound, but is

passively correctable and needs little or no treatment to be

resolved. " Real " clubfoot will need treatment to correct.

One study in London on 14 children published in the Journal of Bone

and Joint surgery in August 2000, indicated that 32% of their sample

really didn't have " true " clubfoot. They said " A total of 32% of

feet required no treatment and so could be considered functional

false-positive results on the scan. "

From Medline is this abstract of the Londond study, " Clinical outcome

of congenital talipes equinovarus diagnosed antenatally by

ultrasound. "

Tillett RL, Fisk NM, K, Hunt DM.

Department of Orthopaedics, St 's Hospital, London, England.

" Congenital talipes equinovarus is a common anomaly which can now be

diagnosed prenatally on a routine ultrasound scan at 20 weeks of

gestation. Prenatal counselling is increasingly offered to parents

with affected fetuses, but it is difficult to counsel parents if

there is a chance that the fetus may not have talipes. Our study

correlates the prenatal ultrasound findings of 14 infants diagnosed

as having unilateral or bilateral talipes during their routine 20-

week ultrasound scan with their clinical findings at birth and the

treatment received. No feet diagnosed as talipes on the ultrasound

scan were completely normal at birth and therefore there were no true

false-positive results. One foot graded as normal at 20 weeks was

found to have a mild grade-1 talipes at birth, but did not require

treatment other than simple stretches. A total of 32% of feet

required no treatment and so could be considered functional false-

positive results on the scan. Serial casting was required by 13% of

feet and surgical treatment by 55%. The severity of the talipes is

difficult to establish before birth. A number of patients are likely

to need surgical treatment, but a proportion will have talipes so

mildly that no treatment will be required. In counselling parents at

20 weeks, orthopaedic surgeons need to know whether or not there is a

small chance that the ultrasound diagnosis could be wrong and also

that the talipes may be so mild that the foot will not require

treatment. "

PMID: 10990315 [PubMed - indexed for MEDLINE]

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?

cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=10990315

The following study indicated that for 103 children born with

clubfoot at an Australian hospital only 25% were picked up on

ultrasounds. The abstract does not say whether or not all of the 103

mothers had had ultrasounds or not.

J Pediatr Orthop 1999 Jan-Feb;19(1):11-3

Prenatal ultrasound diagnosis of clubfoot.

Burgan HE, Furness ME, BK.

Women's and Children's Hospital, Adelaide, South Australia.

Prenatal ultrasound diagnosis of clubfoot is increasing. Of 103

patients with clubfoot diagnosed at birth, 26 (25.2%) positive

prenatal scans were identified with the earliest diagnosis being made

at 15 weeks. A questionnaire assessment indicated that 17 (65.4%)

deemed that the explanation of the baby's condition was clear. With

an increasing incidence of antenatal detection, it is suggested that

parents require adequate antenatal counseling by a specialist in the

area of clubfoot to improve the understanding of the natural history

and treatment of this condition.

PMID: 9890279 [PubMed - indexed for MEDLINE]

and (3-17-99)

http://www.vh.org/pediatric/patient/orthopaedics/clubfeet/egbert.html

> A girl that I have been speaking to who lives in the next town

over from

> mine was told that the child she is carrying has clubfoot. She

isn't due

> until March. Yesterday, she told me that when she had another

ultrasound

> they said it was definitely clubfoot but it wasn't that bad. Can

the level

> of severity be told through ultrasound? Is there a such thing as

telling

> how bad it is or is it that you either have clubfoot or you don't?

> Obviously, I am aware of atypical clubfoot but that is not

diagnosed until

> after birth correct?

>

>

>

>

>

> Mommy to (12-17-98) and

>

> Christian (1-30-04) LCF - DBB 23/7

>

>

>

>

>

>

[Guest guest]

I don't think they can tell the degree of it from the U/S. When they told

me (at 20 week u/s) that was going to have clubfoot, they said it

may not be that severe and that it may even correct itself before birth.

Which I honestly don't see how that can be possible. Anyway, they had no

idea how severe it was and I had several u/s's because I was so worried

about it. It turned out that she had a more severe case than the norm.

Shook

Retail Operations Manager/Baking Instructor

Vie de France Yamazaki, Inc.

2070 Chain Bridge Rd. Suite 500

Vienna, VA 22182

x374

x374

fax

[Guest guest]

My understanding is that they can diagnose the clubbing but the severerity can't

be told until the bundle of joy is here. That is what my ortho told me. He saw

the u/s picts and said, yup that is clubbbed feet, don't know how bad it is till

he is here.

Gerace cgerace@...> wrote:A girl that I have been speaking to

who lives in the next town over from

mine was told that the child she is carrying has clubfoot. She isn't due

until March. Yesterday, she told me that when she had another ultrasound

they said it was definitely clubfoot but it wasn't that bad. Can the level

of severity be told through ultrasound? Is there a such thing as telling

how bad it is or is it that you either have clubfoot or you don't?

Obviously, I am aware of atypical clubfoot but that is not diagnosed until

after birth correct?

Mommy to (12-17-98) and

Christian (1-30-04) LCF - DBB 23/7

[Guest guest]

I was told by both my OBG & Specialist that the severity could not be diagnosed

until after the baby was born. I was seeing a specialist for 2 mo. because they

thought my cervix was funneling - thank god it wasn't but I had several 3D

sonograms to be sure - They still couldn't tell how bad his feet were. In fact,

they guessed it was probably a severe case but after he got here he wasn't as

bad as they originally thought. Those little guys can get into so many

different positions & are so flexible I think it's really hard to determine.

Gerace cgerace@...> wrote:A girl that I have been speaking to

who lives in the next town over from

mine was told that the child she is carrying has clubfoot. She isn't due

until March. Yesterday, she told me that when she had another ultrasound

they said it was definitely clubfoot but it wasn't that bad. Can the level

of severity be told through ultrasound? Is there a such thing as telling

how bad it is or is it that you either have clubfoot or you don't?

Obviously, I am aware of atypical clubfoot but that is not diagnosed until

after birth correct?

Mommy to (12-17-98) and

Christian (1-30-04) LCF - DBB 23/7

[Guest guest]

Hi there I was told at my 14 week U.S. that my son has bcf and they told me that

there was no way of telling how bad it was but that we would have to wait untill

he was born to find that out.

Jen and 07-11-04 bcf 16\7

clubfoot via ultrasound question

A girl that I have been speaking to who lives in the next town over from

mine was told that the child she is carrying has clubfoot. She isn't due

until March. Yesterday, she told me that when she had another ultrasound

they said it was definitely clubfoot but it wasn't that bad. Can the level

of severity be told through ultrasound? Is there a such thing as telling

how bad it is or is it that you either have clubfoot or you don't?

Obviously, I am aware of atypical clubfoot but that is not diagnosed until

after birth correct?

Mommy to (12-17-98) and

Christian (1-30-04) LCF - DBB 23/7