clenched hands

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.

Pathology

Some authors 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
Associations

Several conditions are associated with this observation which include:

Radiographic features

Antenatal ultrasound

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 2 finger overlapping the 3). Its presence in an antenatal ultrasound scan is sometimes classified as a soft sign for aneuploidic anomalies.

Differential diagnosis

On antenatal imaging consider:

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