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Volume 11
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10.3390/diagnostics11050868
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Article

Prenatal Screening for Developmental Displacement of the Hip: The BUDDHA (Pre-Birth Ultrasound for Developmental Displacement of the Hip Assessment) Study

by
Elena Contro
1,*,
Laura Larcher
1,
Jacopo Lenzi
2,
Arianna Benfenati
1,
Giulia Massinissa Magini
3,
Giulia Galeati
1,
Maria Terrone
1,
Silvia Galletti
3,
Santo Arcuri
3,
Anna Seidenari
1 and
Antonio Farina
1
1
Department of Medicine and Surgery, Division of Obstetrics and Prenatal Medicine, IRCCS Sant’Orsola-Malpighi, University of Bologna, 40138 Bologna, Italy
2
Section of Hygiene, Public Health and Medical Statistics, Department of Biomedical and Neuromotor Sciences, Alma Mater Studiorum, University of Bologna, 40138 Bologna, Italy
3
Neonatology Unit, Department of Medical and Surgical Sciences, IRCCS St. Orsola-Malpighi, University of Bologna, 40138 Bologna, Italy
*
Author to whom correspondence should be addressed.
Diagnostics 2021, 11(5), 868; https://doi.org/10.3390/diagnostics11050868
Submission received: 19 April 2021 / Revised: 1 May 2021 / Accepted: 8 May 2021 / Published: 12 May 2021
(This article belongs to the Special Issue Maternal-Fetal Medicine)
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Abstract

Background: developmental dysplasia of the hip has an incidence of 3–5 out of 1000 children. Currently, only postnatal screening is available. Objective: to test the feasibility of a method based on Graf technique application at antenatal ultrasound in assessing the normal development of the hip in unselected term fetuses. Methods: a prospective cohort study in a single university tertiary hospital from January 2017 to January 2020. Single uncomplicated term pregnancies (37–40 weeks) attending our center for routine ultrasound were consecutively recruited for the purpose of the study. A 3D volume acquisition was launched on the coxofemoral joint of the fetus by a single expert operator, and offline analysis was then performed in the multiplanar mode by two operators (blinded to each other analysis) in order to measure the alpha and beta angles according to our modified Graf technique. Intra- and inter-observer variations were calculated. Reference charts for normal values of both angles were produced. Postnatal ultrasound was then performed to measure the Graf angles in newborns, confirming a normal development of the hip. Results: in the study period, 433 uncomplicated term pregnancies underwent 3D ultrasound for the assessment of the fetal hip. One case was subsequently excluded because of confirmed postnatal diagnosis of developmental dysplasia of the hip. The measurement of our modified Graf angles was feasible at prenatal ultrasound with a good reproducibility. The inter-rater and intra-rater reliability of both angles was substantial. Reference charts for normal values of both angles were produced. Conclusions: the evaluation of the coxofemoral joint in fetuses at term of gestation has never been attempted before. The Graf technique application, currently employed at postnatal ultrasound, may also be adapted to prenatal ultrasound with a substantial reproducibility. However, there was no evidence of a linear relationship between prenatal and postnatal alpha angles and beta angles. Further research is needed to establish if developmental dysplasia of the hip could be diagnosed antenatally.
Keywords: alpha and beta angles; Graf technique; antenatal ultrasound; coxofemoral joint; developmental dysplasia of the hip; prenatal screening alpha and beta angles; Graf technique; antenatal ultrasound; coxofemoral joint; developmental dysplasia of the hip; prenatal screening

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MDPI and ACS Style

Contro, E.; Larcher, L.; Lenzi, J.; Benfenati, A.; Massinissa Magini, G.; Galeati, G.; Terrone, M.; Galletti, S.; Arcuri, S.; Seidenari, A.; et al. Prenatal Screening for Developmental Displacement of the Hip: The BUDDHA (Pre-Birth Ultrasound for Developmental Displacement of the Hip Assessment) Study. Diagnostics 2021, 11, 868. https://doi.org/10.3390/diagnostics11050868

AMA Style

Contro E, Larcher L, Lenzi J, Benfenati A, Massinissa Magini G, Galeati G, Terrone M, Galletti S, Arcuri S, Seidenari A, et al. Prenatal Screening for Developmental Displacement of the Hip: The BUDDHA (Pre-Birth Ultrasound for Developmental Displacement of the Hip Assessment) Study. Diagnostics. 2021; 11(5):868. https://doi.org/10.3390/diagnostics11050868

Chicago/Turabian Style

Contro, Elena, Laura Larcher, Jacopo Lenzi, Arianna Benfenati, Giulia Massinissa Magini, Giulia Galeati, Maria Terrone, Silvia Galletti, Santo Arcuri, Anna Seidenari, and et al. 2021. "Prenatal Screening for Developmental Displacement of the Hip: The BUDDHA (Pre-Birth Ultrasound for Developmental Displacement of the Hip Assessment) Study" Diagnostics 11, no. 5: 868. https://doi.org/10.3390/diagnostics11050868

APA Style

Contro, E., Larcher, L., Lenzi, J., Benfenati, A., Massinissa Magini, G., Galeati, G., Terrone, M., Galletti, S., Arcuri, S., Seidenari, A., & Farina, A. (2021). Prenatal Screening for Developmental Displacement of the Hip: The BUDDHA (Pre-Birth Ultrasound for Developmental Displacement of the Hip Assessment) Study. Diagnostics, 11(5), 868. https://doi.org/10.3390/diagnostics11050868

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