Prenatal ultrasound manifestations and classification of 37 fetuses with limb–body wall complex: a retrospective study

TL;DR

This study analyzed prenatal ultrasound features of 37 fetuses with limb–body wall complex to improve early diagnosis and counseling for parents.

Contribution

The study provides a classification system for LBWC based on craniofacial anomalies and describes associated ultrasound features.

Findings

37 fetuses with LBWC were classified into type I (4 cases) and type II (31 cases), with some showing features of both types.

All fetuses had thoracoschisis or gastroschisis with visceral herniation, and most had limb abnormalities and spinal curvature.

Accurate prenatal ultrasound assessment can detect LBWC in the first trimester, aiding clinical decision-making and counseling.

Abstract

This study aimed to provide a clinical reference for prenatal diagnosis by summarizing the ultrasound manifestations and classifications of fetal limb–body wall complex (LBWC).

We retrospectively reviewed cases of LBWC diagnosed through prenatal ultrasound examination at Peking Union Medical College Hospital and Xuzhou Maternal and Child Health Hospital between 2012 and 2023. The primary prenatal ultrasound imaging features and associated malformations were recorded and classified into two categories based on the presence (type I) or absence (type II) of craniofacial anomalies.

Among 37 fetuses with LBWC, 4 were classified as type I, 31 were classified as type II, and 2 exhibited features of both type I and type II concurrently. All fetuses had varying degrees of thoracoschisis or gastroschisis with visceral herniation. A total of 35 fetuses had limb abnormalities, and 11 had craniofacial abnormalities. All fetuses showed varying degrees of spinal curvature, and 23 had umbilical cord abnormalities. In addition, 32 fetuses had other abnormalities, including a persistent extraembryonic coelom in 12 fetuses, an amniotic band in 9 fetuses, nuchal translucency thickening in 5 fetuses, nuchal cystic hygroma in 3 fetuses, an invisible bladder in 2 fetuses, and external genital anomalies in 1 fetus. All cases resulted in induced termination.

Fetal LBWC has characteristic ultrasonographic features and can be diagnosed in the first trimester. An accurate prenatal ultrasound assessment is essential to enable clinicians to offer future parents the necessary information and counseling concerning the prognosis of this type of anomaly.

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