Subscribe to RSS
![](/products/assets/desktop/img/oa-logo.png)
DOI: 10.5999/aps.2016.43.2.153
The Importance of Multidisciplinary Management during Prenatal Care for Cleft Lip and Palate
![](https://www.thieme-connect.de/media/10.1055-s-00051611/201602/lookinside/thumbnails/10_5999_aps_2016_43_2_153_153-1.jpg)
Background The prenatal ultrasound detection of cleft lip with or without cleft palate (CL/P) and its continuous management in the prenatal, perinatal, and postnatal periods using a multidisciplinary team approach can be beneficial for parents and their infants. In this report, we share our experiences with the prenatal detection of CL/P and the multidisciplinary management of this malformation in our institution's Congenital Disease Center.
Methods The multidisciplinary team of the Congenital Disease Center for mothers of children with CL/P is composed of obstetricians, plastic and reconstructive surgeons, pediatricians, and psychiatrists. A total of 11 fetuses were diagnosed with CL/P from March 2009 to December 2013, and their mothers were referred to the Congenital Disease Center of our hospital. When CL/P is suspected in the prenatal ultrasound screening examination, the pregnant woman is referred to our center for further evaluation.
Results The abortion rate was 28% (3/11). The concordance rate of the sonographic and final diagnoses was 100%. Ten women (91%) reported that they were satisfied with the multidisciplinary management in our center.
Conclusions Although a child with a birth defect is unlikely to be received well, the women whose fetuses were diagnosed with CL/P on prenatal ultrasound screening and who underwent multidisciplinary team management were more likely to decide to continue their pregnancy.
Keywords
Cleft lip - Cleft palate - Craniofacial abnormalities - Ultrasonography - Interdisciplinary communicationPublication History
Received: 11 September 2015
Accepted: 28 December 2015
Article published online:
20 April 2022
© 2016. The Korean Society of Plastic and Reconstructive Surgeons. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonCommercial License, permitting unrestricted noncommercial use, distribution, and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes. (https://creativecommons.org/licenses/by-nc/4.0/)
Thieme Medical Publishers, Inc.
333 Seventh Avenue, 18th Floor, New York, NY 10001, USA
-
References
- 1 Abramowicz S, Cooper ME, Bardi K. et al. Demographic and prenatal factors of patients with cleft lip and cleft palate: a pilot study. J Am Dent Assoc 2003; 134: 1371-1376
- 2 Sohan K, Freer M, Mercer N. et al. Prenatal detection of facial clefts. Fetal Diagn Ther 2001; 16: 196-199
- 3 Cash C, Set P, Coleman N. The accuracy of antenatal ultrasound in the detection of facial clefts in a low-risk screening population. Ultrasound Obstet Gynecol 2001; 18: 432-436
- 4 Moss A. Controversies in cleft lip and palate management. Ultrasound Obstet Gynecol 2001; 18: 420-421
- 5 Ministry of Health and Welfare. The necessity for reinforcement of guarantee of insurance for the surgery of cleft lip and palate [gusungugaeyeol susul bojangseongganghwa pilyo] [Internet]. Sejong: Ministry of Health and Welfare. 2013 [cited 2016 Feb 1]. Available from: http://stat.mw.go.kr/front/notice/statPressReleaseView.jsp?menuId=31&bbsSeq=4&nttSeq=20541&nPage=1&searchKey=&searchWord=&sttsDataSeq=
- 6 Christ JE, Meininger MG. Ultrasound diagnosis of cleft lip and cleft palate before birth. Plast Reconstr Surg 1981; 68: 854-859
- 7 Maarse W, Pistorius LR, Van Eeten WK. et al. Prenatal ultrasound screening for orofacial clefts. Ultrasound Obstet Gynecol 2011; 38: 434-439
- 8 Rotten D, Levaillant JM. Two- and three-dimensional sonographic assessment of the fetal face. 2. Analysis of cleft lip, alveolus and palate. Ultrasound Obstet Gynecol 2004; 24: 402-411
- 9 Nyberg DA, Sickler GK, Hegge FN. et al. Fetal cleft lip with and without cleft palate: US classification and correlation with outcome. Radiology 1995; 195: 677-684
- 10 Ministry of Health and Welfare. The research on the actual condition of artificial abortion and establishment of comprehensive countermeasures [ingongimsinjungjeol siltaejosa mich jonghabdaechaegsulib], 2005 [Internet]. Sejong: Ministry of Health and Welfare. 2008 [cited 2016 Feb 1]. Available from: http://stat.mw.go.kr/front/statData/publicationView.jsp?menuId=47&bbsSeq=13&nttSeq=10104&searchKey=&searchWord=&nPage=7
- 11 Nusbaum R, Grubs RE, Losee JE. et al. A qualitative description of receiving a diagnosis of clefting in the prenatal or postnatal period. J Genet Couns 2008; 17: 336-350
- 12 Maarse W, Berge SJ, Pistorius L. et al. Diagnostic accuracy of transabdominal ultrasound in detecting prenatal cleft lip and palate: a systematic review. Ultrasound Obstet Gynecol 2010; 35: 495-502
- 13 Davalbhakta A, Hall PN. The impact of antenatal diagnosis on the effectiveness and timing of counselling for cleft lip and palate. Br J Plast Surg 2000; 53: 298-301
- 14 Lippman A. Embodied Knowledge and Making Sense of Prenatal Diagnosis. J Genet Couns 1999; 8: 255-274
- 15 Hulnick SJ. Ultrasound diagnosis of clefts. Plast Reconstr Surg 1982; 70: 118-119
- 16 Hallock G. In defense of ultrasound diagnosis of cleft lips in utero. Plast Reconstr Surg 1983; 71: 443
- 17 Matthews MS, Cohen M, Viglione M. et al. Prenatal counseling for cleft lip and palate. Plast Reconstr Surg 1998; 101: 1-5
- 18 Duboys EB. Prenatal counseling for cleft lip and palate. Plast Reconstr Surg 1998; 102: 278
- 19 Bronshtein M, Blumenfeld I, Blumenfeld Z. Early prenatal diagnosis of cleft lip and its potential impact on the number of babies with cleft lip. Br J Oral Maxillofac Surg 1996; 34: 486-487
- 20 Blumenfeld Z, Blumenfeld I, Bronshtein M. The early prenatal diagnosis of cleft lip and the decision-making process. Cleft Palate Craniofac J 1999; 36: 105-107
- 21 Wilhelm L, Borgers H. The 'equals sign': a novel marker in the diagnosis of fetal isolated cleft palate. Ultrasound Obstet Gynecol 2010; 36: 439-444
- 22 Kim DW, Chung SW, Jung HD. et al. Prenatal ultrasonographic diagnosis of cleft lip with or without cleft palate; pitfalls and considerations. Maxillofac Plast Reconstr Surg 2015; 37: 24