{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,10]],"date-time":"2025-12-10T15:18:10Z","timestamp":1765379890580,"version":"3.46.0"},"reference-count":42,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2025,9,6]],"date-time":"2025-09-06T00:00:00Z","timestamp":1757116800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Prenatal Diagnosis"],"published-print":{"date-parts":[[2025,10]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To address the current lack of a prenatal classification system for fetal lower limb anomalies, we developed and evaluated the PRELLIM (PREnatal Lower LIMb impairment) classification.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Method<\/jats:title>\n                    <jats:p>A systematic literature review was conducted to identify existing classifications. Based on sonographic features, we developed the PRELLIM classification and applied it to a retrospective cohort of fetuses with isolated lower limb anomalies assessed between 2007 and 2024 at Amsterdam UMC's fetal medicine unit.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      No standardized prenatal classification system for lower limb anomalies was found. PRELLIM distinguishes isolated and non\u2010isolated anomalies and categorizes them into clinically relevant subgroups (absent\/short, duplication, fusion, contracture, bowing and other). It was applied to 643 fetuses with isolated lower limb anomalies. Contractures were most common (\n                      <jats:italic>n<\/jats:italic>\n                      \u00a0=\u00a0599; 93.2%), followed by poly(syn)dactyly (\n                      <jats:italic>n<\/jats:italic>\n                      \u00a0=\u00a026; 4.0%), reduction defects (\n                      <jats:italic>n<\/jats:italic>\n                      \u00a0=\u00a09; 1.5%), bowing (\n                      <jats:italic>n<\/jats:italic>\n                      \u00a0=\u00a05; 0.8%), and a case of sirenomelia (0.1%). Three additional cases (0.4%) were classified as \u201cother\u201d: two lymphangiomas and one amniotic band with lower leg constriction.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>PRELLIM is the first prenatal classification tailored to sonographically detectable lower limb anomalies. It aims to enhance diagnostic consistency, improve interdisciplinary communication, and support prenatal counseling and decision\u2010making.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/pd.6885","type":"journal-article","created":{"date-parts":[[2025,9,6]],"date-time":"2025-09-06T16:09:21Z","timestamp":1757174961000},"page":"1442-1449","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["A Practical Prenatal Ultrasound Classification System for Lower Limb Anomalies\u2014PRELLIM Classification"],"prefix":"10.1002","volume":"45","author":[{"ORCID":"https:\/\/orcid.org\/0009-0007-7157-6014","authenticated-orcid":false,"given":"Arda","family":"Ardu\u00e7","sequence":"first","affiliation":[{"name":"Department of Obstetrics and Gynecology Amsterdam UMC University of Amsterdam  Amsterdam the Netherlands"},{"name":"Amsterdam Reproduction and Development  Amsterdam the Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Margriet H. 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H.","family":"Witbreuk","sequence":"additional","affiliation":[{"name":"Department of Pediatric Orthopedic Surgery Amsterdam UMC University of Amsterdam  Amsterdam the Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Merel C.","family":"Van Maarle","sequence":"additional","affiliation":[{"name":"Department of Human Genetics Amsterdam UMC University of Amsterdam  Amsterdam the Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2463-9127","authenticated-orcid":false,"given":"Elisabeth","family":"van Leeuwen","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Amsterdam UMC University of Amsterdam  Amsterdam the Netherlands"},{"name":"Amsterdam Reproduction and Development  Amsterdam the Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eva","family":"Pajkrt","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Amsterdam UMC University of Amsterdam  Amsterdam the Netherlands"},{"name":"Amsterdam Reproduction and Development  Amsterdam the Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-1509-5182","authenticated-orcid":false,"given":"Ingeborg H.","family":"Linskens","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Amsterdam UMC University of Amsterdam  Amsterdam the Netherlands"},{"name":"Amsterdam Reproduction and Development  Amsterdam the Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2025,9,6]]},"reference":[{"key":"e_1_2_11_2_1","unstructured":"EUROCAT.Prevalence Charts and Tables the Netherlands 2007\u20102019 https:\/\/eu\u2010rd\u2010platform.jrc.ec.europa.eu\/eurocat\/eurocat\u2010data\/prevalence_en."},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.j2249"},{"issue":"1","key":"e_1_2_11_4_1","first-page":"1","article-title":"Update on Overall Prevalence of Major Birth Defects\u2014Atlanta, Georgia, 1978\u20132005","volume":"57","author":"Centers for Disease Control and Prevention (CDC)","year":"2008","journal-title":"MMWR Morb Mortal Wkly Rep"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1053\/jhsu.2001.26121"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.1002\/ajmg.a.37240"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.5772\/intechopen.76108"},{"key":"e_1_2_11_8_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.24888"},{"key":"e_1_2_11_8_2","doi-asserted-by":"crossref","unstructured":"https:\/\/doi.org\/10.1002\/uog.24888.","DOI":"10.1002\/uog.24888"},{"key":"e_1_2_11_9_1","unstructured":"Kwaliteitseisen Tweede Trimester SEO (Structureel Echoscopisch Onderzoek) Versie 8.1 2022 NVOG. 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