[tri-med] Re: foot length

----- Original Message ----- 
From: <Annee122884
>>Our textbook states, "One  quick and
> effective way to estimate gestational age is by measuring foot  length. 
> Foot
> length of appropriate-for-gestational-age preterm infants has  been 
> correlated
> with gestational age." My question is, do you know of trisomies  that 
> present
> with altered foot length/shape. Don't some trisomy kids have rocker 
> bottom
> feet?

There are a few "assumptions" here. Are you talking about in-utero foot 
length or foot length after birth?

Firstly textbooks refer to the "norm" - so for the "normal" pregnancy yes I 
guess that foot length would be a quick guesstimate of gestational age for a 
"typical" infant whose only complication was prematurity but from my 
experience its not the usual thing that they look for.

There are other markers for gestational age after birth that are much more 
reliable eg nails (the nails are soft and do not reach the ends of the 
nails, especially on the toes) and nail beds, eyelashes and eyebrows, amount 
of lanugo etc.
Also rocker bottom feet are not going to effect foot length because the 
"rocker" part is due to muscle insertion not bone length.

There is also a difference between prematurity and IUGR. A baby who is 
suffering from IUGR can have some or none of the subtle signs of 
prematurity, they can simply be small for dates.

Prenatally the standard test for gestational age is crown rump length - that 
is the length between the babies crown and rump. Used in conjunction with 
femur length. The earlier that this measure is taken is the more reliable 
that it is and thats because IUGR doesn't actually become apparent until 
after 11 weeks. IUGR is detected when the earlier measurements don't 
correspond with later measurements. Thats one of my beefs regarding Alex's 
birth. We had initial meausrements done at 7 1/2 weeks, therefore by their 
own admission quite accurate, and no one picked up the continuing downward 
slide of the CRL and FL to his gestational age. But then the same 
sonographers also over-estimated his birth weight by 50%.

Now this is something that I have looked into for my own personal 
information - what I have been told is what doctors are prepared to testify 
to in court. No one has mentioned foot length but they certainly have talked 
about crown rump length, femur length, birth weight, lanugo, and nails to 
death. From personal experience I can tell you that Alex was born at 36 
weeks + gestation but his foot was small, very very very small. We had to 
reduce dolls bootee patterns to get them to fit - for knitters we used 12 
stitches in 4 ply, so thats about 1 1/2 to 2 inches long. But then again he 
was proportionally small all over, consistent with IUGR. His nails and such 
were apparently consistent with 36 weeks +

Life consists not in holding good cards but in playing those you hold well.
                                            -- Josh Billings

Keep Looking For Rainbows!!
   _--_|\
 /Karen \
 \ _.--._ /
          v Karen, Mum to Alex (12 years, T-18 Mosaic)
http://members.optushome.com.au/karens

                  Building ___ooOOoo__ Rainbows
                       www.trisomyonline.org
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