Year: 2024
Type: conference-abstract
Abstract: Short femur below 5 percentile or less than 2SD is often considered as a marker for skeletal dysplasia or chromosomal abnormalities. It can also be seen in SGA fetuses. There is no robust data about the association of short femur with markers of uteroplacental insufficiency. The association of short femur with placental dysfunction may be due to altered levels of fibroblast growth factor 2 in abnormal placentation or due to preferential shunting of highly oxygenated fetal blood towards vital organs sparing the extremities. The objective of the study is to identify the association of short femur with other markers of uteroplacental insufficiency and SGA fetuses and to determine whether a short femur can be a pointer to placental insufficiency. This is a retrospective case analysis of 45 cases of short femur with normal postnatal outcomes of which 60% were referred to us as skeletal dysplasia. Syndromic conditions with abnormal bone morphology were excluded from the study. Markers of uteroplacental insufficiency assessed in this group were namely 1. mean uterine PI > 90% 2. fetal AC/EFW <10 percentile 3.CPR abnormalities. Of the 45 cases, 17% of cases presented with short femur at early anomaly scan, 71% at mid-trimester anomaly scan and 11% in third trimester growth scan. The associated findings of placental dysfunction present in this cohort were as follows: high mean uterine artery PI was seen in 35.5%, 77.7% were associated with AC/EFW <10 percentile and CPR abnormalities were found in 31% of fetuses. The likelihood that isolated short femur is associated with placental dysfunction is very high and needs to be given first priority before considering other causes like skeletal dysplasia or chromosomal abnormality. About 77% of these fetuses were associated with AC/EFW <10 percentile and these fetuses needs to be carefully monitored subsequently in the third trimester for growth and Doppler abnormality. Thus a short femur can be an early pointer towards underlying placental insufficiency.
DOI: 10.1002/uog.28332
Authors: A. Murugan Rajee, P. Pawadi, M.P. Thamizharasan, K. Natarajan, M. Arulmozhi, S. Lakshmy
Institution: Shri Lakshmi Clinic & Scan Centre
Language: English
Subfield: Obstetrics and Gynecology
Field: Medicine
Domain: Health Sciences
Open Access status: bronze
OpenAlex ID: W4402359394