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sonography should be referred to specific postnatal data sets to compare for survival chances,
treatment options, and results.6 Classifications
divide hand anomalies into 7 types according to
the severity of the deformity: from the least severe
involvement with hypoplasia alone (type 1) to the
most severe involvement, in which no functional
digits are present (type 7). Our case of a hand
anomaly would be classified as type 7 Poland
syndrome with an additional chest deformity.
Upper limb anomalies and syndactyly can also
be associated with other syndromes, such as
CHILD syndrome (congenital hemidysplasia with
ichthyosiform erythroderma and limb defects),
Holt-Oram syndrome, and Apert syndrome.7
Figure 1. A, Second-trimester 3D sonogram showing the radial and ulnar dysplasia of the right forearm and the aplasia of the
right hand, in contrast to the normally developed left hand of
the fetus. B, Second-trimester 3D sonogram showing the whole
upper right limb with the right hand aplasia in close-up. The
radial and ulnar dysplasia is also shown.
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References
Accurate depiction of the defect on 3D sonography can help in better predicting physical development. Its high specificity was confirmed in our
case (to our knowledge the first case with antenatal 3D sonography of the upper limb published)
by postnatal radiography of the right arm.
Possible malformations that may coexist with
Poland syndrome have been described in the different body systems,5 making a thorough physical
examination antenatally and postnatally necessary. In a recent study concerning the antenatal
sonographic diagnosis of skeletal dysplasias, it
was shown that a specific confirmation of the dysplasias severity is often possible by prenatal
sonography alone. In inconclusive cases, sonog-
1.
2.
Lord MJ, Laurenzano KR, Hartmann RW Jr. Polands syndrome. Clin Pediatr (Phila) 1990; 29:606609.
3.
4.
5.
6.
Paladini D, DArmiento MR, Martinelli P. Prenatal ultrasound diagnosis of Poland syndrome. Obstet Gynecol
2004; 104:11561159.
7.
8.
Schramm T, Gloning KP, Minderer S, et al. Prenatal sonographic diagnosis of skeletal dysplasias. Ultrasound Obstet
Gynecol 2009; 34:160170.
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