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Prenatal counseling for cleft lip and palate
M S Matthews1, M Cohen, M Viglione
1Division of Plastic Surgery, Cooper Hospital/University Medical Center, University of Medicine and Dentistry of New Jersey, Robert Wood Johnson Medical School at Camden, USA.
Insights
Prenatal diagnosis of cleft lip and palate is possible via ultrasound. Families receiving this diagnosis often report inadequate information and find consultations with cleft teams highly valuable.
Area of Science:
- Plastic Surgery
- Obstetrics
- Genetics
Background:
- Prenatal diagnosis of cleft lip and palate (CLP) can be identified during routine or high-resolution obstetrical ultrasounds.
- Families or obstetricians may seek plastic surgery consultation following a prenatal CLP diagnosis.
- Understanding the characteristics and needs of this patient population is crucial for effective care.
Purpose of the Study:
- To define the population of newborns referred to a cleft program with a prenatal diagnosis of CLP.
- To assess the adequacy of information provided to families regarding cleft diagnoses.
- To evaluate the perceived value of prenatal consultations with a cleft team.
Main Methods:
- A survey was conducted among families referred to a cleft program between 1990 and 1994 with a prenatal CLP diagnosis.
- Data collected included the incidence of different cleft types and follow-up information from participating families.
- Statistical analysis (chi-square test) was used to compare cleft incidences.
Main Results:
- Of 80 referred newborns, 13 had a prenatal CLP diagnosis.
- Children with prenatal diagnoses showed a significantly higher incidence of bilateral cleft lip and palate (53.8%) compared to the general population (28.7%, p < 0.03).
- No isolated cleft palates were identified prenatally; only one-third of families felt adequately informed by their obstetrician or ultrasonographer.
Conclusions:
- Prenatal diagnosis of CLP is feasible but may be associated with a higher proportion of bilateral cases.
- There is a significant need for improved communication and information dissemination regarding CLP diagnoses to expectant families.
- Prenatal consultations with specialized cleft teams are perceived as valuable and beneficial for affected families.
Abstract:
Prenatal diagnoses of cleft lip and palate can occur during both routine screening obstetrical ultrasound and high resolution obstetrical ultrasound done for other reasons. The affected family or obstetrician may request prenatal consultation with the plastic surgeon. To define this population, a survey was done of all families who were referred to our cleft program with a prenatal diagnosis of cleft between 1990 and 1994. Of 80 newborn referrals, 13 had a prenatal diagnosis of cleft. These children had a higher incidence of bilateral cleft than our average population (53.8 percent versus 28.7 percent, p < 0.03, chi square test). No isolated cleft palates were identified. Nine families were available for follow-up. Only one-third of the families felt that they had been given adequate information about clefts from their obstetrician or ultrasonographer. All who had prenatal contact with the cleft team felt it was valuable. A review of prenatal diagnosis of cleft is given including limitations. Specific counseling information is discussed.