Natural history of 70 fetuses with a prenatally diagnosed orofacial cleft.
OBJECTIVE
This study is an analysis of neonatal outcome in 70 fetuses diagnosed over a 10-year period as having cleft lip with or without cleft palate (CL-P) by ultrasonographic examination.


METHODS
We describe the natural history of these 70 fetuses with orofacial clefts and select those who may be candidates for fetal surgery. The sonograms of 70 fetuses with orofacial clefts were evaluated for the nature of the CL-P and for the nature of the associated anomalies. Additionally, karyotyping was performed in 63 of 70 patients (90%).


RESULTS
The frequency of additional anomalies and the mortality rate varied with the type of cleft. Also, the frequency and type of chromosomal abnormalities varied with the type of cleft. The overall mortality rate was 63% (n = 44). 3 of the surviving 26 fetuses had severe associated anomalies. In 13 of the remaining 23 cases, the fetal age at diagnosis (> or =22 weeks) excluded the fetuses from the potential benefits of fetal intervention.


CONCLUSIONS
Of 70 fetuses with prenatally diagnosed orofacial clefts, only 10 (14%) were candidates for fetal CL-P surgery.
Bergé
Stefaan J
SJ
Department of Oral and Maxillofacial Surgery, Division of Prenatal Diagnosis and Therapy, Friedrich Wilhelm University, Sigmund-Freud-Strasse 25, D-53105 Bonn, Germany. s.berge@uni-bonn.de
Plath
Hanno
H
von Lindern
Jens J
JJ
Appel
Thorsten
T
Niederhagen
Bernd
B
Van de Vondel
Patricia T
PT
Hansmann
Manfred
M
D000328:Adult; D002869:Chromosome Aberrations; D002971:Cleft Lip / Q000000981:diagnostic imaging* / Q000235:genetics / Q000401:mortality / Q000601:surgery; D002972:Cleft Palate / Q000000981:diagnostic imaging* / Q000235:genetics / Q000401:mortality / Q000601:surgery; D005260:Female; D005865:Gestational Age; D006801:Humans; D007231:Infant, Newborn; D011247:Pregnancy; D011256:Pregnancy Outcome; D016216:Ultrasonography, Prenatal