THE SIGNIFICANCE OF ULTRASONOGRAPHICALLY DIAGNOSED FETAL WRIST POSITION ANOMALIES

OBJECTIVE: Our purpose was to determine the clinical significance of u ltrasonographically diagnosed fetal wrist position anomalies. STUDY DE SIGN: The relationship of the fetal hand to the forearm was prospectiv ely evaluated in all second- and third-trimester scans over a 5-year p eriod. If an abnormal wrist position was detected, a targeted scan, in cluding echocardiography, was performed. The outcomes of abnormal preg nancies were obtained. RESULTS: An abnormal relationship of the hand t o the forearm was found in 22 fetuses in 27,467 scans. Nine had a norm al karyotype, and 13 had an abnormal karyotype. Among the nine with no rmal chromosomes, three had evidence of a movement disorder. Three wit h normal karyotypes are alive; two of these are the only normally func tioning survivors. They had no other major anomalies and were shown pr enatally to have normal movement of the limbs. CONCLUSIONS: An abnorma l fetal wrist position is associated with a high incidence of karyotyp e and movement abnormalities.