Diagnosis of fetal isolated cleft palate using assessment of the posterior hard palate angle
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Published on: September 19, 2015
Iglika Ivancheva Simeonova-Brachot1
1Department of Obstetrics and Gynecology, University Hospital of Poitiers, Poitiers, France.
Insights
The posterior hard palate angle is a reliable ultrasound marker for prenatal diagnosis of cleft palate without cleft lip. This measurement can significantly aid in identifying affected fetuses with high accuracy.
Area of Science:
- Medical Imaging
- Prenatal Diagnosis
- Craniofacial Anomalies
Background:
- Cleft palate is a common congenital condition.
- Accurate prenatal diagnosis is crucial for effective management.
- Distinguishing cleft palate from other conditions prenatally can be challenging.
Purpose of the Study:
- To assess the utility of the posterior hard palate angle in the prenatal ultrasound diagnosis of isolated cleft palate.
- To determine if this angle can differentiate between cleft palate, high-arched palate, and normal palate structures.
Main Methods:
- Retrospective analysis of stored axial transverse view ultrasound images of the fetal secondary palate.
- Inclusion of unaffected cases, suspected cleft palate without cleft lip, confirmed cleft palate, high-arched palate, and false-positive cases.
- Measurement of the posterior hard palate angle and statistical analysis.
Main Results:
- The posterior hard palate angle was significantly larger in fetuses with cleft palate compared to healthy controls and false-positive cases (227° vs. 160°/173°, p < 0.0001).
- The posterior angle remained an independent risk factor for cleft palate (OR 58.67).
- The assessment demonstrated a sensitivity of 73% and a specificity of 96% for detecting cleft palate.
Conclusions:
- The posterior hard palate angle serves as a valuable ultrasound marker for the prenatal detection of cleft palate without a cleft lip.
- This measurement can improve diagnostic accuracy in prenatal screening for craniofacial abnormalities.
Objective:
The study aims to evaluate the role of the posterior hard palate angle in the prenatal diagnosis of cleft palate.
Study Design:
Stored images of the axial transverse view of the fetal secondary palate, obtained at three-level obstetric ultrasounds, were used to evaluate the posterior border of the hard palate. The study population comprised 63 consecutive pregnancies of unaffected cases and 17 pregnancies suspected for a cleft palate without cleft lip, including 7 cases of cleft palate, 4 cases of high-arched palate, and 6 false-positive cases.
Results:
The posterior angle of the hard palate was significantly larger in the cleft palate group than in the healthy controls and false-positive cases: 227° (±51°) vs 160° (±16°), p < 0.0001; and 173° ± 18°, p < 0.0001, respectively. Regression analysis revealed that reflex angle remained an independent risk factor for cleft palate (odds ratio, 58.67 (95% confidence interval 10-341)). The sensitivity and specificity of the posterior angle assessment were 73% and 96%, respectively.
Conclusions:
The posterior hard palate angle could be an ultrasound marker of cleft palate without a cleft lip.
