EP07.25: Prenatal diagnosis of cleft palate: performance and outcome

To assess the diagnostic accuracy of 2D-ultrasound (US) axial-transverse view in detecting cleft palate in the Prenatal Diagnosis Unit of Obstetrics and Gynecology I of the Emergency University County Hospital. This is a retrospective single-centre 3-year study. The secondary palate is routinely assessed in axial view during the first trimester (FT) and the second trimester (ST) anomaly scan. Data were extracted from the patients' hard-copy and electronic files in the intranet network Hipocrat used by the Hospital. The US examinations were reviewed using the stored unit's external hard drives. Patient records on terminations of pregnancy (TOPs) and neonates with cleft palate were reviewed to validate the diagnoses. We found 9 cases diagnosed prenatally in our unit. Among them, eight fetuses were diagnosed at the first presentation in the unit. In 3 cases the diagnosis was reached at the end of the FT, 5 in the ST, and one case was diagnosed at term. Cleft palate was diagnosed postnatally in 3 newborns, all these pregnancies having suboptimal or no prenatal care. The sensitivity, specificity, positive predictive value, and negative predictive value of US in axial-transverse views were 100%, 98.7%, 76.4%, 100%. We had an overall 41.66% (5/12) termination rate due to isolated cleft and 100% (3/3) in cases diagnosed in the FT. All parents facing this diagnosis in early pregnancy requested medical termination, despite the favourable multidisciplinary repeated counselling. Technological advances and operators' skills allow the prenatal early diagnosis of cleft palate in an axial-transverse view. It seems that parents perceive this facial defect as a severely life-limiting one. Please note: The publisher is not responsible for the content or functionality of any supporting information supplied by the authors. Any queries (other than missing content) should be directed to the corresponding author for the article.