Etiologies and Adverse Outcomes of Fetuses with Short Femur Length Based on Proportion and Percentile Categorization

doi:10.37015/AUDT.2021.210015

Advanced Ultrasound in Diagnosis and Therapy ›› 2022, Vol. 6 ›› Issue (1): 7-13.doi: 10.37015/AUDT.2021.210015

• Original Research • Previous Articles Next Articles

Etiologies and Adverse Outcomes of Fetuses with Short Femur Length Based on Proportion and Percentile Categorization

Jianan Li, BS^a, Hong Xu, MD^a, Mei Shen, BS^a, Shiyu Li, BS^a, Longxia Wang, MD^a^,^*(), Yanping Lu, MD^b^,^*(), Qiuyang Li, MD^a^,^*()

^aDepartment of Ultrasound, First Medical Center, Chinese PLA General Hospital, Beijing, China
^bDepartment of Gynecology and Obstetrics, First Medical Center, Chinese PLA General Hospital, China

Received:2021-06-02 Revised:2021-06-28 Online:2022-03-30 Published:2022-03-01
Contact: Longxia Wang, MD,Yanping Lu, MD,Qiuyang Li, MD, E-mail:13693685342@163.com;luyp301@163.com;Liqiuyang0925@163.com

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Abstract

Abstract:

Objective: To compare the etiologies and adverse outcomes of pregnancies with short fetal femur length (FL) categorized based on relative proportion and percentile placement.
Methods: Fetuses (n = 254) with short FL measured by ultrasound were classified into four groups: severe and disproportionate short FL (group A); severe and proportionate short FL (group B); mild and disproportionate short FL (group C); mild and proportionate short FL (group D). Etiologies and outcomes of pregnancies were compared between groups.
Results: A larger percentage of skeletal dysplasia occurred in group A (28.57%) than in the other three groups (group B: 1.85%; group C: 4.08%; group D: 0). Groups A and B also had higher rates (group A: 40.82%, group B:33.33%) of fetal growth restriction (FGR) than groups C and D (group C: 4.08%; group D:3.92%). No difference in chromosomal and genetic anomalies was detected among groups (P = 0.307); however, the rate of chromosomal and genetic testing in group A was higher than in group D (P = 0.001). Group A (57.14%) had a significantly lower rate of live birth than the other three groups, and group D (98.04%) had a higher live birth rate than groups B (87.04%) and C (83.67%). Considering only living fetuses, higher rates of preterm birth (P < 0.001), low birth weight (LBW) (P < 0.001), neonatal intensive care unit (NICU) admission or pediatric hospital referral (P = 0.004), Apgar score (1 min/5 min) ≤7 (P < 0.001) and fetal distress or neonatal asphyxia (P = 0.004) were found in group A compared to group D.
Conclusion: Fetuses with severe and disproportionate short FL should be flagged for possible skeletal dysplasia. Fetuses with severe short FL should be watched for FGR prenatally. Invasive prenatal tests are recommended for fetuses with severe and disproportionate FL but not recommended for those with mild and proportionate short FL. Outcomes of fetuses with severe and disproportionate short FL were worse than that of fetuses with mild and proportionate short FL.

Key words: Short fetal femur length; Disproportionate; Etiologies; Outcomes

Jianan Li, BS, Hong Xu, MD, Mei Shen, BS, Shiyu Li, BS, Longxia Wang, MD, Yanping Lu, MD, Qiuyang Li, MD. Etiologies and Adverse Outcomes of Fetuses with Short Femur Length Based on Proportion and Percentile Categorization. Advanced Ultrasound in Diagnosis and Therapy, 2022, 6(1): 7-13.

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Etiologies and Adverse Outcomes of Fetuses with Short Femur Length Based on Proportion and Percentile Categorization

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