Document Detail


First-trimester diagnosis of cleft lip and palate using three-dimensional ultrasonography.
MedLine Citation:
PMID:  22081485     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
OBJECTIVE: To determine whether systematic examination of the primary and secondary palate with 3D ultrasound aids in the identification of orofacial clefts in the first trimester. METHODS: 3D datasets were acquired prospectively from women undergoing first-trimester ultrasound screening for aneuploidy. Multiplanar mode display was used for off-line analysis of (1) the primary palate in the coronal plane at the base of the retronasal triangle and (2) the secondary palate by virtual navigation in the axial plane. In addition, 3D datasets from 3 fetuses having a cleft palate diagnosed in the first trimester were retrospectively identified and included randomly in the study group. RESULTS: A total of 240 3D datasets from 237 pregnancies (including 3 sets of twins) were examined independently by 3 operators, of which 89% were obtained transabdominally and 11% transvaginally. Quality of the 3D datasets was classified subjectively as good, fair, and poor in 76%, 20%, and 4% of cases, respectively. 7 fetuses had an orofacial cleft; all involved both the primary and secondary palate. Using 3D offline analysis, the primary palate was classified as intact in 229 (95%), clefted in 9 (4%), and indeterminate in 2 (1%). 7 of the 9 fetuses suspected to have a cleft affecting the primary palate were confirmed at birth or postmortem examination (false positive rate 22%). The secondary palate was classified as intact in 217 (90%), clefted in 6 (3%), and indeterminate in 17 (7%). Clefts of the secondary palate were confirmed in all the 6 suspected cases and missed in 1, which was diagnosed at 16 weeks. The visualization rate was affected by the quality of the 3D dataset (p<0.001) and gestational age at evaluation (p<0.01). CONCLUSION: In our series, all cases of clefting of the primary palate and 86% of cases involving the secondary palate were visualized using 3D ultrasound with a satisfactory false positive rate. Virtual navigation of the fetal palate using the multiplanar mode display seems to be useful in the diagnosis of clefting in the first trimester. Copyright © 2011 ISUOG. Published by John Wiley & Sons, Ltd.
Authors:
P Martinez-Ten; B Adiego; T Illescas; C Bermejo; A E Wong; W Sepulveda
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2011-11-11
Journal Detail:
Title:  Ultrasound in obstetrics & gynecology : the official journal of the International Society of Ultrasound in Obstetrics and Gynecology     Volume:  -     ISSN:  1469-0705     ISO Abbreviation:  -     Publication Date:  2011 Nov 
Date Detail:
Created Date:  2011-11-14     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9108340     Medline TA:  Ultrasound Obstet Gynecol     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
Copyright © 2011 ISUOG. Published by John Wiley & Sons, Ltd.
Affiliation:
Delta-Ultrasound Diagnostic Center in Obstetrics and Gynecology, Madrid, Spain.
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