Prenatal diagnosis of congenital talipes equinovarus: favorable outcome is highly dependent on the absence of associated anomalies

OBJECTIVE:  The aim of this study was to evaluate the demographic characteristics, prenatal findings, and outcomes of prenatally diagnosed congenital talipes equinovarus at a tertiary center.

METHODS:  A retrospective cohort study was conducted on 78 fetuses diagnosed with congenital talipes equinovarus between 2013 and 2023. Data on gestational age at diagnosis, laterality, associated anomalies, genetic results, and pregnancy outcomes were analyzed.

RESULTS:  The mean gestational age at diagnosis was 21±3.83 weeks. Congenital talipes equinovarus was bilateral in 60.3% of cases. Isolated congenital talipes equinovarus was present in 30.8% of cases, while 69.2% had associated anomalies, most commonly neural tube defects (32.6% of non-isolated cases). Of the 46 cases (59%) that underwent genetic analysis, 13 (28.3%) revealed abnormalities, representing 16.7% of the total cohort. Termination of pregnancy occurred in 59% of cases due to associated anomalies or genetic abnormalities. Thirty pregnancies resulted in live birth, with a prenatal diagnosis accuracy of 90%. The three false-positive cases were associated with oligohydramnios or early gestation. Postnatally, most live-born cases with confirmed congenital talipes equinovarus (77.8%) required serial casting and surgery.

CONCLUSION:  The prognosis for prenatally diagnosed congenital talipes equinovarus is excellent in isolated cases, supported by the absence of genetic abnormalities in this group. However, the high frequency of associated anomalies drastically alters prognosis, frequently leading to pregnancy termination and highlighting the critical need for comprehensive prenatal screening and multidisciplinary counseling.

KEYWORDS:
Clubfoot; Congenital talipes equinovarus; Prenatal diagnosis; Ultrasonography