Prenatal diagnosis of micrognathia and postnatal identification of cleft soft palate: A case report

This case report details the prenatal diagnosis of fetal micrognathia using advanced ultrasound techniques and highlights its role in anomaly detection and perinatal management. A 33-year-old primigravida presented for routine antenatal care at 30 weeks of gestation. Ultrasound revealed mandibular hypoplasia with an Inferior Facial Angle (IFA) of 46.2° (below the diagnostic threshold of 50°) and a reduced Jaw Index, confirming micrognathia. Three-dimensional ultrasound provided additional visualization of the retronasal triangle, where the absence of a normal mandibular gap further supported the diagnosis. Biometric parameters, including head circumference and femur length, were within normal limits. The neonate, delivered at 38 weeks via spontaneous labor, weighed 3.2 kg with Apgar scores of 8 and 9 at 1 and 5 minutes, respectively. Postnatal examination confirmed micrognathia and revealed a cleft soft palate, undetected on prenatal imaging. No airway intervention was required at birth, and surgical correction of the cleft palate was planned at 8 months of age. We present a case that underscores the reliability of prenatal ultrasound, particularly the use of objective criteria like IFA and Jaw Index, in diagnosing micrognathia. It also highlights the importance of multidisciplinary management for optimizing outcomes and addressing associated anomalies. The findings emphasize the need for comprehensive postnatal evaluation and continued advancements in prenatal imaging techniques.