Brief Answer: Wait for Amniocentesis result Detailed Answer: Hi Welcome to Healthcare-Magic Greetings of the day Dear Ms, I am Pediatric Surgeon by profession and actively involved in antenatal counselling of fetal anamolies and Antenatal/post natal intervention . Being a parent myself, I understand your concern and apprehensions. First and foremost its important to consider the following 1.Ethnic/race adjusted femoral or Humerus length are used in interpretation of the length 2. Stature of parents also plays a role 3. The following fetal ultrasound measurements should be visualized and plotted against normative values * fetal cranium (biparietal diameter and head circumference) * facial profile, mandible, clavicle, scapula, chest circumference, vertebral bodies, all fetal long bones, and the hands and feet. Fetuses with long bone parameters >3 SD below the mean(less than 5th percentile) should be strongly suspected of having a skeletal dysplasia, especially if the head circumference is greater than the 75th percentile. Other causes which needs to suspected apart from Trisomy 21(Down's Syndrome) in the presence of short long bones especially involving both femur and humerus is 1. Intra-uterine Growth Retardation 2. Small for Gestational age baby Majority of the times its not lethal, that means babies are born normal and the shortened length of bones could be constitutional without any associated abnormality. Next step to be done is to find out the lethality. Lethality should be determined by chest circumference to abdominal circumference ratio and/or femur length to abdominal circumference measurement ratio. A chest-to-abdominal circumference ratio of <0.6 or femur length to abdominal circumference ratio of 0.16 strongly suggests a perinatal lethal disorder, although there are exceptions. I would assume this has already been done and lethal malformation have been excluded. Amniocentesis will rule out Chromosomal abnormality like Down's Syndrome. I would like to reassure you that if the other parameters like HC,BPD,AC are normal and Chromosomal abnormality has been ruled out then there seems to be less cause for concern and the short long bones could be due to 1. A Normal Variation depending on the ethnic group 2. IUGR 3. Small for Gestational baby 4. Skeletal dysplasia I would suggest you to plan your delivery in institute where good Neonatal care and Pediatric Surgery backup is available. Final assessment and evaluation is possible after delivery. I would suggest you to go ahead with amniocentesis to rule out chromosomal abnormality and if its rule out, there seems to be less cause for concern. Do get back to me if you need any further assistance, will be glad to assist you. Take Care Best Regards Dr Deepak Kishore MBBS,MS,MCH Consultant Pediatric Surgeon

---

Brief Answer: Take Care Detailed Answer: Dear Ms XXXX The ratio is acceptable. Lets wait for amniocentesis with crossed fingers. Its very much likely to be normal. Wish you a happy motherhood. Take Care Regards Deepak

---