An Observational Study on Pre-natal Diagnosis of Congenital Talipes Equinovarus

Introduction: Congenital talipes equinovarus (CTEV), or clubfoot, is a common congenital lower limb disorder. Pre-natal diagnosis using ultrasound (US) enables early identification, facilitating timely intervention and improving outcomes. Understanding the diagnostic accuracy and implications of pre-natal CTEV detection is essential for effective clinical management. Materials and Methods: This observational cohort study evaluated pre-natal US accuracy in detecting CTEV. Two thousand singleton pregnancies between 18 and 24 weeks of gestation were included. Exclusions applied to complicate and multiple pregnancies. Participants underwent anomaly scans, with fetal lower limbs assessed for clubfoot indicators. Follow-up included post-natal examinations and Pirani scoring for confirmed cases. Diagnostic accuracy metrics, including sensitivity, specificity, and predictive values, were calculated. Results: Among live births, pre-natal US identified CTEV cases, with final confirmation distinguishing structural from positional deformities. The study found high sensitivity and specificity, reinforcing US’s reliability for early detection. All affected cases were successfully treated using the Ponseti method, avoiding surgical intervention. Discussion: Despite its effectiveness, US remains operator-dependent, necessitating standardized protocols to reduce misdiagnosis. Early detection benefits psychological preparedness and treatment planning. Future research should assess long-term functional outcomes and optimize pre-natal screening protocols, particularly in resource-limited settings, to ensure comprehensive CTEV management. Keywords: Congenital talipes equinovarus, clubfoot, ankle equinus, hindfoot varus, forefoot adductus, midfoot cavus, pre-natal ultrasound.

Abstract licence: CC BY-NC

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