Prenatal ultrasound manifestations and classification of 37 fetuses with limb–body wall complex: a retrospective study

Objective: This study aimed to provide a clinical reference for prenatal diagnosis by summarizing the ultrasound manifestations and classifications of fetal limb-body wall complex (LBWC). Methods: We retrospectively reviewed cases of LBWC diagnosed through prenatal ultrasound examination at Peking Union Medical College Hospital and Xuzhou Maternal and Child Health Hospital between 2012 and 2023. The primary prenatal ultrasound imaging features and associated malformations were recorded and classified into two categories based on the presence (type I) or absence (type II) of craniofacial anomalies. Results: Among 37 fetuses with LBWC, 4 were classified as type I, 31 were classified as type II, and 2 exhibited features of both type I and type II concurrently. All fetuses had varying degrees of thoracoschisis or gastroschisis with visceral herniation. A total of 35 fetuses had limb abnormalities, and 11 had craniofacial abnormalities. All fetuses showed varying degrees of spinal curvature, and 23 had umbilical cord abnormalities. In addition, 32 fetuses had other abnormalities, including a persistent extraembryonic coelom in 12 fetuses, an amniotic band in 9 fetuses, nuchal translucency thickening in 5 fetuses, nuchal cystic hygroma in 3 fetuses, an invisible bladder in 2 fetuses, and external genital anomalies in 1 fetus. All cases resulted in induced termination. Conclusion: Fetal LBWC has characteristic ultrasonographic features and can be diagnosed in the first trimester. An accurate prenatal ultrasound assessment is essential to enable clinicians to offer future parents the necessary information and counseling concerning the prognosis of this type of anomaly.