Abnormal Number of Fetal Ribs on 3-Dimensional UltrasonographyAssociated Anomalies and Outcomes in 75 Fetuses

20151030

Objective.

The purpose of this study was to describe the clinical importance of an abnormal number of fetal ribs.

Methods.

Static 3- or 4-dimensional volume contrast imaging

75 fetuses with an abnormal number of ribs (2004.08-2007.08)

> 24 < 24

5 fetuses : the number of ribs at 15 weeks < 22-24 weeks

12 pairs

11+12 12 pairs

13 pairs 12+13

15 24

5 fetuses : the number of ribs at 15 weeks < 22-24 weeks

12 pairs

11+12 12 pairs

13 pairs 12+13

Reexamination at 22-24 weeks

2415

75 fetuses with an abnormal number of ribs

53 no additional anomalies

24 with additional anomalies

All 72 fetuses that continued to birth were alive and well and were not found to be dysmorphic on pediatric examinations.

Only 3 neonates had chest radiography after delivery: 1 for bronchopulmonary sequestration and 2 by maternal request.

assosiated genetic disease

assosiated genetic disease

11 rib pairs in neonates with trisomy 21 : 28-33%

37% of the 75 patients in this study elected to have a karyotype examination

all were normal

Spondylocostal dysostosis

autosomal recessively inherited

malformations of the vertebral column and ribs

shortened thorax

moderate to severe scoliosis and kyphosis

https://en.wikipedia.org/wiki/Spondylocostal_dysostosis

Jarcho-Levin Syndrome

short trunk and neck

slightly protuberant abdomen

long arms

RL = -0.5834 + 0.2030 (GA)Rib Length (cm) GA (weeks)

http://onlinelibrary.wiley.com/doi/10.1046/j.1469-0705.1996.07030193.x/pdf

Fetal growthFetal skeletal dysplasia

32-year-old G2P1 karyotype: Trisomy21

http://onlinelibrary.wiley.com/doi/10.1002/uog.2785/epdf

Conclusion

(1) in cases of an isolated finding, patients were told that it was most probably a variation of normal

(2) detailed explanations of the limitations of the study were provided to patients

(3) counseling was given according to the additional anomalies that were found

(4) genetic counseling and risk calculation for trisomy 21 were recommended

The ossification process is completed at puberty.