Fetal Hands: A Comprehensive Review of Prenatal Assessment and Diagnosis Over the Past 40 Years

Gabriele Tonni, Gianpaolo Grisolia, Maria Paola Bonasoni, Giuseppe Rizzo, Heron Werner, Waldo Sepulveda, Rodrigo Ruano, Edward Araujo Júnior

Research output: Contribution to journalReview articlepeer-review


Fetal skeletal dysplasias involving limbs and hands are rare congenital malformations. Prenatal two-dimensional ultrasound diagnosis of fetal limb defects has a sensitivity of about 30%; however, an increased detection rate may be obtained using three-dimensional (3-D) ultrasound in the rendering mode. 3-D ultrasound may be used as a complementary method providing additional information. Currently, magnetic resonance imaging (MRI), with the emergence of ultrafast imaging techniques and new sequences, allows for better diagnosis of several fetal skeletal dysplasias such as limb reduction defects and neuromuscular disorders. 3-D volumetric images from ultrasound or MRI scan data allow 3-D ultrasound reconstructions of virtual/physical models, and virtual reality can help researchers to improve our understanding of both normal and abnormal fetal limb/hand anatomy. In this article, we review the embryological development of fetal hands and their main anomalies including prenatal diagnostic methods, genetic counseling, the role of orthopedic and plastic surgery reconstruction, and new perspectives in fetal surgery.

Original languageEnglish (US)
Pages (from-to)657-676
Number of pages20
JournalUltrasound in Medicine and Biology
Issue number3
StatePublished - Mar 2023


  • Fetal hands
  • Limb reduction defects
  • Magnetic resonance imaging
  • Three-dimensional ultrasound
  • Two-dimensional ultrasound
  • Ultrasound detection rate

ASJC Scopus subject areas

  • Radiological and Ultrasound Technology
  • Biophysics
  • Acoustics and Ultrasonics


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