Fetal clenched hands are an antenatal ultrasound observation where the fetal hands are in a constant (permanently) clenched position as if being unable to extend.
Some authors 3 suggest that the abnormal posture results in part from
- muscle variations along the radial margin of the forearm and hand
- the absence of thenar muscles, anomalous tendons and attachments among the forearm groups
- fusion among the arm flexor group
Several conditions are associated with this observation which include
- aneuploidic syndromic
- non aneuploidic syndromic
Real time images are best for assessment where the fetal hands can be directly observed in a persistent clenched position. Often there may also be overlapping fetal fingers (particularly 2nd finger overlapping the 3rd). Its presence in an antenatal ultrasound scan is sometimes classified as a soft sign for aneuploidic anomalies.
On antenatal imaging consider
- fetal akinesia-hypokinesia syndromes: hand in a temporarily clenched position
- 1. Bromley B, Benacerraf B. Abnormalities of the hands and feet in the fetus: sonographic findings. AJR Am J Roentgenol. 1995;165 (5): 1239-43. AJR Am J Roentgenol (abstract) - Pubmed citation
- 2. Rypens F, Dubois J, Garel L et-al. Obstetric US: watch the fetal hands. Radiographics. 26 (3): 811-29. doi:10.1148/rg.263055113 - Pubmed citation
- 3. Quintero RA, Johnson MP, Mendoza G et-al. Ontogeny of clenched-hand development in trisomy 18 fetuses: A serial transabdominal fetoscopic observation. Fetal. Diagn. Ther. 14 (2): 68-70. Fetal. Diagn. Ther. (link) - Pubmed citation
- 4. Ryu JK, Cho JY, Choi JS. Prenatal sonographic diagnosis of focal musculoskeletal anomalies. Korean J Radiol. 4 (4): 243-51. Korean J Radiol (link) - Free text at pubmed - Pubmed citation