title: The accuracy of prenatal ultrasound in determining the type of orofacial cleft.
abstract: OBJECTIVE
  The aim of this study was to assess the accuracy of prenatal transabdominal ultrasound in determining the oral cleft type.
  
  
  METHODS
  A retrospective cohort study was performed on all consecutive cases of orofacial cleft diagnosed by prenatal ultrasound examination in the Wilhelmina Children's Hospital, a tertiary referral hospital, between January 2002 and December 2012. Prenatal findings were compared with postnatal diagnoses.
  
  
  RESULTS
  A total of 134 patients were included. The mean gestational age at ultrasound examination was 24 weeks + 5 days. Prenatal diagnosis was in accordance with postnatal findings in 76.9% of the cases (103/134) with regard to the cleft type. Underestimation of the cleft occurred in 19.4% (26/134), whereas in 3.7% (5/134), the extent was overestimated. In distinguishing bilateral from unilateral clefts, no errors were made.
  
  
  CONCLUSIONS
  Prenatal ultrasound is accurate in assessing the types of orofacial clefts in a large majority of the cases and is completely accurate in distinguishing between unilateral and bilateral clefts. This study indicates that it is a reliable technique to assess the cleft type, which is important for counseling future parents. Although, the clinician should be aware of the fact that a cleft palate is easily missed, and subsequently, underestimation of cleft extend is frequent.
authors.affiliation: Division of pediatric plastic surgery, Wilhelmina Children's Hospital, Utrecht, The Netherlands.
authors.forename: C S
authors.initials: CS
authors.lastname: Loozen
authors.affiliation: Division of pediatric plastic surgery, Wilhelmina Children's Hospital, Utrecht, The Netherlands.
authors.forename: W
authors.initials: W
authors.lastname: Maarse
authors.affiliation: Department of Obstetrics and Gynecology, University Medical Center Utrecht, Utrecht, The Netherlands.
authors.forename: G T R
authors.initials: GT
authors.lastname: Manten
authors.affiliation: Department of Obstetrics and Gynecology, University Medical Center Utrecht, Utrecht, The Netherlands.
authors.forename: L
authors.initials: L
authors.lastname: Pistorius
authors.affiliation: Division of pediatric plastic surgery, Wilhelmina Children's Hospital, Utrecht, The Netherlands.
authors.forename: C C
authors.initials: CC
authors.lastname: Breugem
mesh_terms: D002971:Cleft Lip / Q000000981:diagnostic imaging*; D002972:Cleft Palate / Q000000981:diagnostic imaging*; D003937:Diagnosis, Differential; D003951:Diagnostic Errors / Q000706:statistics & numerical data*; D005260:Female; D005500:Follow-Up Studies; D005865:Gestational Age; D006801:Humans; D007231:Infant, Newborn; D008297:Male; D011247:Pregnancy; D012189:Retrospective Studies; D016216:Ultrasonography, Prenatal