Challenges in evaluating the fetal face – diagnosis and management

Abstract

Ultrasound assessment of the fetal face represents the first way of interaction of the parents with their unborn baby, therefore this kind of evaluation is gaining followers worldwide, as it is useful in developing a strong maternal-fetal bonding. It is acknow­ledged that an important number of genetic disorders are associated with various degrees of facial anomalies. The ultrasound appearance of the fetal face is influenced by gestational age, as it varies significantly during gestation. In most of the countries, the anomaly scan is performed between 18 and 22 weeks of gestation. Fetal face structures can be assessed by using various reference scanning planes such as axial, coronal, sagittal and oblique views. Due to its importance, most ultrasound societies, including the Romanian Society of Ultrasound in Obstetrics and Gynecology (SRUOG), have published guidelines in order to standardize the fetal face assessment during the first- and second-trimester screening scan. We present a series of particular cases of fetal facial anomalies diagnosed at first- and second-trimester anomaly scans that certify the need of complying with the protocols for fetal face assessment and also the usefulness of additional techniques for the detection of more subtle findings.