First trimester physiological development of the fetal foot position using three-dimensional ultrasound in virtual reality.

Abstract

AIM:

In anatomic studies of the embryo, it has been established that during the development of the lower limb, several changes in foot position can be observed defined as a temporary 'physiological clubfoot'. The aim of this study was to develop and test a measurement tool for objective documentation of the first trimester foot position in vivo and made an attempt to create a chart for first trimester foot position.

METHODS:

We developed a virtual orthopedic protractor for measuring foot positioning using three-dimensional virtual reality visualization. Three-dimensional ultrasound volumes of 112 pregnancies of women examined during the first trimester were studied in a BARCO I-Space. The frontal angle (plantar flexion) and the lateral angle (adduction) between the leg and foot were measured from 8 until 13 weeks gestational age.

RESULTS:

We observed that the frontal angle steadily decreases, whereas the lateral angle first increases, resulting in transient physiological clubfeet position at 10- to 11-week gestation, followed by a decrease to a normal foot position.

CONCLUSION:

A transient clubfoot position is present during the normal development of the lower limbs, and it has been measured in vivo for the first time. This study emphasizes that a diagnosis of congenital clubfoot should not be made in the first trimester of pregnancy.

• Authors: Hein Bogers, Maria S Rifouna, Titia E Cohen-Overbeek, Anton H J Koning, Sten P Willemsen, Peter J van der Spek, Régine P M Steegers-Theunissen, Niek Exalto, Eric A P Steegers
• Journal: The journal of obstetrics and gynaecology research (J Obstet Gynaecol Res) Vol. 45 Issue 2 Pg. 280-288 (Feb 2019) ISSN: 1447-0756 [Electronic] Australia
• PMID: 30450690 (Publication Type: Journal Article)
• Copyright: © 2018 The Authors. Journal of Obstetrics and Gynaecology Research published by John Wiley & Sons Australia, Ltd on behalf of Japan Society of Obstetrics and Gynecology.

Topics

• Adolescent
• Adult
• Embryo, Mammalian (diagnostic imaging)
• Female
• Foot (diagnostic imaging, growth & development)
• Humans
• Pregnancy
• Pregnancy Trimester, First
• Ultrasonography, Prenatal (methods)
• Virtual Reality
• Young Adult