Fetal Hands: A Comprehensive Review of Prenatal Assessment and Diagnosis Over the Past 40 Years

• Published in: Ultrasound in medicine & biology Vol. 49; no. 3; pp. 657 - 676
• Main Authors: Tonni, Gabriele, Grisolia, Gianpaolo, Bonasoni, Maria Paola, Rizzo, Giuseppe, Werner, Heron, Sepulveda, Waldo, Ruano, Rodrigo, Araujo Júnior, Edward
• Format: Journal Article
• Language: English
• Published: England Elsevier Inc 01.03.2023
• Subjects: Female; Fetal hands; Fetus - diagnostic imaging; Hand - diagnostic imaging; Humans; Limb reduction defects; Magnetic resonance imaging; Magnetic Resonance Imaging - methods; Pregnancy; Prenatal Diagnosis - methods; Three-dimensional ultrasound; Two-dimensional ultrasound; Ultrasonography; Ultrasonography, Prenatal - methods; Ultrasound detection rate; Limb reduction defects; Magnetic resonance imaging; Two-dimensional ultrasound; Fetal hands; Ultrasound detection rate; Three-dimensional ultrasound
• ISSN: 0301-5629; 1879-291X
• DOI: 10.1016/j.ultrasmedbio.2022.09.022

Fetal skeletal dysplasias involving limbs and hands are rare congenital malformations. Prenatal two-dimensional ultrasound diagnosis of fetal limb defects has a sensitivity of about 30%; however, an increased detection rate may be obtained using three-dimensional (3-D) ultrasound in the rendering mode. 3-D ultrasound may be used as a complementary method providing additional information. Currently, magnetic resonance imaging (MRI), with the emergence of ultrafast imaging techniques and new sequences, allows for better diagnosis of several fetal skeletal dysplasias such as limb reduction defects and neuromuscular disorders. 3-D volumetric images from ultrasound or MRI scan data allow 3-D ultrasound reconstructions of virtual/physical models, and virtual reality can help researchers to improve our understanding of both normal and abnormal fetal limb/hand anatomy. In this article, we review the embryological development of fetal hands and their main anomalies including prenatal diagnostic methods, genetic counseling, the role of orthopedic and plastic surgery reconstruction, and new perspectives in fetal surgery.