DIAGNOSTIC ACCURACY OF ULTRASOUND LN PRENATAL DIAGNOSIS OF CLUBFOOT ASSOCIATED WITH FETAL ANOMALIES

Background: Congenital talipes equinovarus (clubfoot) is a common musculoskeletal deformity present at birth, affecting approximately 1 to 2 per 1,000 live births globally. Early prenatal identification through ultrasonography provides an opportunity for timely counseling, preparation, and intervention. However, data on the diagnostic reliability of ultrasound in lower-resource or community-level settings remain limited, warranting further investigation to establish its accuracy across diverse populations. Objective: To evaluate the diagnostic accuracy of prenatal ultrasound in detecting clubfoot, using postnatal clinical examination as the gold standard, and to assess the influence of maternal and fetal factors on diagnostic outcomes. Methods: A cross-sectional study was conducted over six months at the Radiology Department of a tertiary care hospital. A total of 215 pregnant women beyond 24 weeks of gestation with singleton pregnancies and sonographic suspicion of foot anomalies were enrolled. All ultrasound examinations were performed using the Voluson E10 3D imaging system. Clubfoot was diagnosed when persistent abnormal foot positioning and angles were observed in multiple views. At delivery, a pediatrician clinically confirmed the presence or absence of clubfoot, and findings were matched with prenatal ultrasound outcomes. Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and overall diagnostic accuracy were calculated using SPSS version 25. Results: Ultrasound demonstrated a sensitivity of 77.78%, specificity of 94.12%, PPV of 77.78%, NPV of 94.12%, and an overall diagnostic accuracy of 90.70%. Diagnostic performance improved in pregnancies beyond 28 weeks and among those with normal maternal BMI and amniotic fluid index. Accuracy was reduced in mothers with diabetes or hypertension. Conclusion: Prenatal ultrasound is a highly reliable tool for detecting clubfoot in the late second and early third trimesters, especially under optimal maternal and fetal conditions. Its routine inclusion in anomaly screening can enhance early diagnosis and newborn care.