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Antenatal Ultrasound Detection of Cleft in Western Australia from 2003 to 2012: A Follow-Up Study
Insights
Antenatal detection rates for cleft lip and palate (CLP) in Western Australia have significantly improved, with most cases now identified before birth. This enhances early counseling for families managing CLP.
Area of Science:
- Medical Imaging
- Pediatric Surgery
- Genetics
Background:
- Cleft lip and palate (CLP) presents significant challenges for affected children and families.
- Antenatal detection of CLP is crucial for timely intervention and parental counseling.
- Previous studies have documented antenatal detection rates in Western Australia.
Purpose of the Study:
- To analyze trends in antenatal detection rates for cleft lip and palate (CLP) patients.
- To compare current detection rates with historical data from 1996-2003.
- To evaluate the impact of improved antenatal detection on cleft management.
Main Methods:
- Retrospective survey of antenatal transabdominal ultrasound screenings.
- Inclusion of infants born between July 1, 2003, and June 30, 2012.
- Data collected from referrals to the Cleft Lip and Palate Unit at Princess Margaret Hospital for Children.
Main Results:
- Significant increase in oral cleft detection rates compared to 1996-2003 (P < .05).
- Overall detection rate of 71.7% for clefts involving lip and palate.
- Higher detection rates by specialist obstetricians (84.6%) versus non-specialists (67.1%).
- Most detections occurred between 15-20 weeks of gestation.
Conclusions:
- Antenatal detection rates for oral clefts, particularly those involving the lip, have improved substantially in Western Australia.
- The majority of mothers are now referred to a cleft unit antenatally.
- Antenatal counseling is now a standard component of cleft management due to improved detection rates.
Aim:
To investigate trends in the rate of antenatal detection of cleft lip and palate (CLP) patients referred to the CLP Unit at Princess Margaret Hospital for Children in Perth, Western Australia during the period 2003-2012 and compare data with a previously published report covering the years 1996-2003.
Methods:
This is a single-center, retrospective survey of antenatal transabdominal ultrasound screenings of mothers of infants born between July 1, 2003 and June 30, 2012 that were referred to the CLP Unit at Princess Margaret Hospital.
Results:
Detection rates of oral clefts increased significantly when compared with outcomes reported in the same population between 1996 and 2003 (P < .05). An overall detection rate of 71.7% (165/230) was achieved for clefts involving lip and palate. Detection of isolated cleft palate (1/99) and microform (0/8) remained elusive. Most detections (76.5%) were achieved at 15 to 20 weeks of gestational age, corresponding with routine anatomical screening. A further 16.8% were detected post-20 weeks of gestation. Scans were performed by specialist obstetricians, and sonography clinics reported a detection rate of 84.6% (55/65), whereas nonspecialist clinics reported a detection rate of only 67.1% (110/164).
Conclusion:
The antenatal detection rates of oral clefts involving the lip have improved to the extent that the majority of mothers are now being referred to a cleft unit in Western Australia prior to the births of their children. As a result of this improvement, antenatal counseling is now a common facet of cleft management.
