OP18.07: Isolated cleft lips: interest of ‘Cupid's bow’

Abstract

Objectives: To evaluate usefulness of sagittal CDUS images for the differential diagnosis of fetal cleft lip (CL) and cleft palate (CP). Methods: We got coronal and axial images of upper lip and maxillary alveolar in 25 fetuses with CL and CP. Existence of defect and malalignment of alveolar was assessed. We assessed existence of hard palate defect on the mid-sagittal image and flow through the defect on CUDS during fetal swallowing. We compared the US findings with postnatal features. We assessed the accuracy of axial and sagittal images in the differential diagnosis of CL and CP. Results: 19 cases had CL and CP. 6 cases had CL without CP. 3 of 6 CL cases had cleft alveolar. Alveolar defect on axial image was detected in 18 of 19 cases with CP and 3 of 6 with CL. Alveolar malalignment was detected in 11 of 19 cases with CP, but in no case with CL. Hard palate defect on the sagittal image was detected in 15 of 19 cases with CP, but in no case with CL. CDUS evaluation of fetal swallowing was possible in 20 of 25 cases. Communicating flow through the palate defect was detected in 14 of 15 cases with CP, but in no case with CL. The accuracy of alveolar defect and malalignment on axial image were 84% and 68%, respectively. Accuracy of hard palate defect and flow on mid-sagittal image were 84% and 95%, respectively. Combined axial and sagittal images correctly diagnosed in all 6 cases with CL and 18 of 19 cases with CP. The accuracy was 96%. Conclusions: Sagittal US evaluation of the fetal hard palate may have additional value in the differential diagnosis of fetal CL and CP.