The infant’s fists are clenched, with overlapping of 3rd and 4th fingers. Which of the following is most likely diagnosis?

A neonate is very small for gestational age and shows hypotonia and marked skeletal muscle and subcutaneous fat hypoplasia. During delivery, a large volume of amniotic fluid was released at rupture of membranes. The placenta was small, and only a single umbilical artery was noted. The face has a pinched appearance with hypoplastic orbital ridges, short palpebral fissures and a small mouth and jaw. The head is small with prominence of the occipital. The ears are low set and malformed. The infant’s fists are clenched, with overlapping of 3rd and 4th fingers. Which of the following is most likely diagnosis?

A. Type 1 collagen defect
B. Type 4 collagen defect
C. Trisomy 13
D. Trisomy 18
E. Trisomy 21