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Craniofacial variability index determined by three-dimensional ultrasound in isolated vs. syndromal fetal cleft
N M Roelfsema1, W C J Hop, L N A van Adrichem
1Department of Obstetrics and Gynecology, Erasmus MC, University Medical Centre Rotterdam, The Netherlands. NMRoelfsema@hotmail.com
Objective:
This study was undertaken to employ craniofacial pattern profile analysis in fetal facial clefts and to evaluate the craniofacial variability index (CVI) in distinguishing between isolated and syndromal clefts.
Methods:
Three-dimensional (3D) sonographic assessment of 16 different fetal craniofacial measurements was performed in each of eight pregnancies complicated by an isolated facial cleft and seven pregnancies with a syndromal cleft. The measurements covered various aspects of facial width, depth and height. Measured values were compared to gestational age-specific normal values for calculation of Z-scores and the CVI. The number of abnormal Z-scores, i.e. < - 2 or > + 2, found among the measured values and the CVI in the group of isolated facial clefts were compared to those in the group with syndromal clefts.
Results:
The CVI could be calculated in 14 of 15 fetuses (93%). More abnormal Z-scores and a higher mean CVI were found in the group with more severe (bilateral) facial clefts. Most abnormal values were found in the facial width measurements. Syndromal cleft lip/palate was associated with significantly more abnormal Z-scores and a higher mean CVI than isolated cleft lip/palate (P < 0.05).
Conclusion:
Craniofacial variability index may be a valuable tool for distinguishing between isolated and syndromal fetal cleft lip/palate.
