Cleft lip and palate

Antenatal ultrasound scan

Routine antenatal fetal ultrasound scanning at approximately 18 weeks' gestation can identify the possible presence of a cleft lip. In such cases of positive antenatal ultrasound, involvement of maternal-fetal specialists and genetic counselling is recommended.[37]Gagnon A, Wilson RD, Allen VM, et al; Society of Obstetricians and Gynaecologists of Canada. Evaluation of prenatally diagnosed structural congenital anomalies. J Obstet Gynaecol Can. 2009 Sep;31(9):875-81. http://www.ncbi.nlm.nih.gov/pubmed/19941713?tool=bestpractice.com In one systematic review, routine, 2-dimensional ultrasound resulted in a low antenatal detection rate of oro-facial clefts in utero. However, 3-dimensional ultrasound showed accurate diagnostic accuracy for detection of antenatal cleft lip and cleft lip with or without cleft palate. Three-dimensional ultrasound did not show any increased accuracy in detecting cleft palate alone.[36]Maarse W, Bergé SJ, Pistorius L, et al. Diagnostic accuracy of transabdominal ultrasound in detecting prenatal cleft lip and palate: a systematic review. Ultrasound Obstet Gynecol. 2010 Apr;35(4):495-502. http://onlinelibrary.wiley.com/doi/10.1002/uog.7472/full http://www.ncbi.nlm.nih.gov/pubmed/20235140?tool=bestpractice.com This knowledge gives parents the opportunity to gather information and access available support systems. Antenatal consultation with a cleft and cranio-facial team surgeon to explain and develop the initial postnatal treatment plan enables the parents to understand and become involved in the complex, multi-disciplinary management of the condition.