Evaluation of fetal midface anatomy related to facial clefts: use of US.

Abstract

Important aspects of fetal midface anatomy that relate to facial clefts can be observed in utero at prenatal sonography in the coronal and axial planes.

Two‐ and three‐dimensional sonographic assessment of the fetal face. 1. A systematic analysis of the normal face

“…For example, the generally reported rates of prenatal recognition of cleft lip range between 21% and 30%3, 4, 8, 11–14. However, when all three planes of the face are systematically examined, the detection rate increases to 88%15. This figure is close to rates reported in tertiary centers, where facial examination is part of the work‐up for fetuses suspected to have an anomaly on a previous study or for high‐risk patients16.…”

Value of sagittal color Doppler ultrasonography as a supplementary tool in the differential diagnosis of fetal cleft lip and palate

“…The importance of a sagittal scan, therefore, has been described with a limited view toward detecting “premaxillary protrusion(s)” when bilateral CL with or without CP was suspected in coronal or axial scans. Babcook et al [16] reported that the echogenic fusion line of the secondary palate was seen in only 26% of in utero fetuses in sagittal sonograms and in 100% of normal fetal specimens.…”

Ultrasound Imaging of the Fetal Palate

“…The presence of cleft lip detected in this view leads to further assessment of the fetal palate. The conventional assessment of the fetal face and anterior part of the palate involves the evaluation of these structures in the axial and coronal planes, which could be obtained in 68-95% of fetuses in the mid-trimester (Pretorius 1995, Babcook 1996. The structures to be assessed in the orthogonal planes are as follows: The sagittal view (or the facial profile) is not always helpful especially in the case of unilateral facial cleft because the view could be very much near normal.…”