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The Importance of Multidisciplinary Management during Prenatal Care for Cleft Lip and Palate
Hyun Ho Han1, Eun Jeong Choi1, Ji Min Kim1
1Department of Plastic and Reconstructive Surgery, College of Medicine, The Catholic University of Korea, Seoul, Korea.
Insights
Prenatal ultrasound detection of cleft lip with or without cleft palate (CL/P) and multidisciplinary management improved parental decisions to continue pregnancies. This approach offers beneficial continuous care for affected infants and families.
Area of Science:
- Medical Science
- Obstetrics
- Pediatric Surgery
Background:
- Prenatal ultrasound is crucial for detecting cleft lip with or without cleft palate (CL/P).
- A multidisciplinary team approach is beneficial for managing CL/P throughout prenatal, perinatal, and postnatal periods.
- This report details experiences with prenatal CL/P detection and management at a Congenital Disease Center.
Purpose of the Study:
- To evaluate the effectiveness of prenatal CL/P detection.
- To assess the impact of a multidisciplinary team approach on management outcomes.
- To understand parental decision-making regarding continuing pregnancy after CL/P diagnosis.
Main Methods:
- A Congenital Disease Center multidisciplinary team (obstetricians, surgeons, pediatricians, psychiatrists) managed mothers of fetuses with CL/P.
- Eleven fetuses diagnosed with CL/P between March 2009 and December 2013 were referred to the center.
- Referral occurred upon suspicion of CL/P during prenatal ultrasound screening.
Main Results:
- The abortion rate was 28% (3/11) among the studied cases.
- Sonographic and final diagnoses showed 100% concordance.
- 91% of women reported satisfaction with the multidisciplinary management provided.
Conclusions:
- Prenatal diagnosis of CL/P via ultrasound, coupled with multidisciplinary management, increases the likelihood of continuing pregnancy.
- Despite the challenges of birth defects, supportive care influences parental decisions positively.
- The multidisciplinary team approach is vital for managing CL/P and supporting affected families.
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.
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