Ultrasound antenatal diagnosis of cleft palate by a new technique

the 3D ‘reverse face’ view

CAMPBELL, S.
LEES, C.
MOSCOSO, G.
HALL, P.

^*Create Health Clinic, Harley Street, Imperial College, London, UK
‡National Heart and Lung Institute, Imperial College, London, UK
†Divisions of Fetal–Maternal Medicine, Addenbrookes NHS Trust, Cambridge, UK
§East of England Cleft Lip and Palate Service, Addenbrookes NHS Trust, Cambridge, UK

Correspondence to: S. Campbell, Create Health Clinic, 103–105 Harley Street, London W1G 6AJ, UK ([email protected])

Accepted: 15 November 2004

Ultrasound in Obstetrics & Gynecology 25(1):p 12-18, January 2005.

Objective

To assess the clinical value of a novel three-dimensional (3D) ultrasound technique, the reverse face view (3D RF view), in the antenatal categorization of facial clefting and in particular clefting of the hard palate.

Methods

Eight cases of suspected orofacial clefting were examined by 3D surface rendering. The fetal lips and alveolar ridge were examined in the frontal plane and the face was then rotated through 180° on the vertical axis to examine the secondary palate by the 3D RF view.

Results

In each case described, we were able to visualize the fetal face, lips and palate and make an antenatal diagnosis as to whether the palate was affected. In all cases, the antenatal diagnosis was subsequently confirmed. In one case with a left-sided cleft in the lips and alveolar ridge and an intact hard palate, the correct diagnosis was made but a cleft in the soft palate was missed.

Conclusion

Although clefts of the lips and alveolar ridge are readily diagnosed on high-quality antenatal ultrasound, visualization of the fetal palate using existing techniques is unreliable. In the patients described here, the 3D RF technique allowed relatively straightforward assessment of the fetal palate with a high degree of accuracy.