The 2D axial transverse views of the fetal face: A new technique to visualize the fetal hard palate; methodology description and feasibility

Abstract

The ATV is an easy, simple, and accessible 2D method to visualize the FHP with no additional time.

Ultrasound imaging of the fetal secondary palate: Methodological description of a two‐dimensional approach and a case series

“…We completely agree with the conclusion stated by the authors “… This easy and accessible technique, according to the angle of insonation, enables to overcome the main difficulty in that situation: the shadowing of the maxillar ridge. Images are of true quality and could be obtained by sonographers with no 3D experience and during routine scan ….” Our study provide further support to this notion, both by plotting a growth curve of reproducible measurements obtained during 2D routine obstetric scans, from as early as 14 weeks gestation, and by the prenatal diagnosis of secondary palate clefts by using only these direct 2D images.…”

“…Pilu and Segata called it the angled insonation approach in their 3D US volume acquisition, enabling them to avoid shadowing within the reconstructed multiplanar view of the secondary palate. Recently, Tutschek and Blaas further demonstrated how this insonation approach, enables a shadow free volume, once initiated from the same plane as Fuchs et al described in their 2D series of mid trimester scans. In that study by Fuchs et al, the authors showed that a direct 2D visualization of the secondary palate is feasible in 95% of cases during second trimester scans, at first attempted.…”

“…In addition, 3D US requires specific machines, 3D US qualified operators, and consume more time for image processing. This notion was recently supported by Tutschek and Blaas and by Fuchs et al who published a methodology study showing the feasibility of the horizontal plate visualization on 2D US during the 21 to 24 weeks routine scan, with high successes rates . During our routine scans, we implement the same 2D approach to study the fetal palate, keeping in mind two basic principles: First, the normal zipper like closure process during the development of the bonny secondary palate, in a rostral to caudal direction, ending in a transverse bony border to which the muscular soft palate anchor .…”

A score‐based method for quality control of fetal hard palate assessment during routine second‐trimester ultrasound examination

“…When an orofacial cleft lip is discovered, precise characterization of this malformation is necessary and especially the extension of this cleft to the secondary palate. Assessing the secondary fetal palate can be performed through a two‐dimensional (2D) ultrasound technique or by the use of multiplanar or tomographic reconstructions provided by three‐dimensional (3D) ultrasonography …”

“…Regarding the visualization of the secondary palate, the main reasons for failure advocated by sonographers are not only the difficulty of obtaining a clear image of the palate, but also ensuring that the palate structure is correctly identified. Recently, we published a study demonstrating that visualization of the fetal hard palate through an axial transverse 2D view was feasible in 95% during routine second‐trimester scans …”