title: Three-dimensional ultrasound demonstration of the fetal palate in high-risk patients: the accuracy of prenatal visualization.
abstract: OBJECTIVE
  The aim of this research was to evaluate the ability of three-dimensional (3D) ultrasound for demonstrating the palate of fetuses at high risk for cleft palate.
  
  
  METHODS
  Fifty-seven fetuses at high risk for cleft palate were referred for specialist ultrasound at 12-40 weeks' gestation. A detailed assessment of palate was made using both two-dimensional and 3D ultrasounds on the axial plane. Antenatal diagnoses were compared with postnatal findings.
  
  
  RESULTS
  Cleft palate was suspected in 13 (22.8%); a normal palate was demonstrated in 38 (67%), and in six (10.2%), the palate view could not be obtained. Mean gestational age at the first visit was 27 weeks 6 days (range of 12-40 weeks 3 days). Examination after delivery revealed that one of the 38 fetuses with presumed normal palate had a cleft hard palate, and one had a cleft soft palate (false negative 5%). Among the 13 fetuses with suspected cleft palate, three had an intact palate (false-positive 23%). Sensitivity, specificity, positive predictive value, and negative predictive value of detection of palatal clefts were 71.4%, 91.9%, 62.5%, and 94.4%, respectively.
  
  
  CONCLUSIONS
  Using 3D technology, we diagnosed a cleft palate in 83% of high-risk cases, with 5% false negative. 3D technology might produce some technical artifacts resulting in a 23% false-positive rate.
authors.affiliation: Department of Obstetrics and Gynecology, The Chaim Sheba Medical Center, Ramat-Gan, Israel. liat@dr-gindes.co.il
authors.forename: Liat
authors.initials: L
authors.lastname: Gindes
authors.forename: Alina
authors.initials: A
authors.lastname: Weissmann-Brenner
authors.forename: Michal
authors.initials: M
authors.lastname: Zajicek
authors.forename: Boaz
authors.initials: B
authors.lastname: Weisz
authors.forename: Alon
authors.initials: A
authors.lastname: Shrim
authors.forename: Keren
authors.initials: K
authors.lastname: Tzadikevitch Geffen
authors.forename: David
authors.initials: D
authors.lastname: Mendes
authors.forename: Jaacov
authors.initials: J
authors.lastname: Kuint
authors.forename: Michal
authors.initials: M
authors.lastname: Berkenstadt
authors.forename: Reuven
authors.initials: R
authors.lastname: Achiron
mesh_terms: D002972:Cleft Palate / Q000000981:diagnostic imaging* / Q000453:epidemiology; D005260:Female; D005333:Fetus / Q000002:abnormalities; D005865:Gestational Age; D006801:Humans; D021621:Imaging, Three-Dimensional / Q000379:methods / Q000706:statistics & numerical data; D007231:Infant, Newborn; D010159:Palate / Q000000981:diagnostic imaging*; D011247:Pregnancy; D011256:Pregnancy Outcome / Q000453:epidemiology; D012189:Retrospective Studies; D012307:Risk Factors; D012680:Sensitivity and Specificity; D016216:Ultrasonography, Prenatal / Q000379:methods* / Q000706:statistics & numerical data