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Clinical insights with your finger tips
A. Dall'Asta, G. Paramasivam, C. C. Lees | April 2017 | Ultrasound in Obstetrics & Gynecology
Orofacial clefts (OFCs) represent one of the most common fetal abnormalities, with an incidence of 1 in 500–1000 live births1,2. Following a diagnosis of OFC, providing accurate antenatal counseling and assessment of the postnatal implications and management of the findings are of primary importance for the parents3. Indeed, OFCs can be diagnosed in the context of genetic syndromes, particularly if they are bilateral, involve the secondary palate and/or are associated with additional structural abnormalities or ultrasound markers4. The detection rate of cleft lip on conventional two-dimensional (2D) ultrasound screening has increased over recent decades, being as high as 65% in some centers4–7. Nevertheless, clear visualization of the posterior or secondary palate is not possible with 2D sonography6,8,9. Cleft extension into the secondary palate has significant prognostic implications in terms of surgical and functional outcomes6. Three-dimensional (3D) imaging technologies have provided the opportunity to develop novel approaches to identify fetal facial features and provide more informed counseling and adequate preparation for the prospective parents. Several 3D ultrasound techniques for assessment of the secondary palate, which comprises the hard and soft palate, have been described (Table 1)5,6,8,10–12, nevertheless, there is no consensus as to which has clinical superiority10.