Accuracy of the second trimester screening in the diagnosis of cleft lip and palate

Abstract

Objectives: To demonstrate the reliability of the screening of the mid trimester in the diagnosis of facial clefts through a sequential approach with 2D and 3D ultrasound. Materials and methods: We identified 6 cases of facial clefts in the examination of fetal morphological screening of the mid trimester. All cases were investigated both with two-dimensional ultrasound scans and with reconstructions in 3D ultrasound. The scans used for diagnosis were: axial scan, sagittal and coronal scan; while rendering used for diagnosis were: Surface rendering, Multiplanar Reconstruction Mode and Maximum Mode/Transparent Mode. Results: All 6 cases identified in screening had a postnatal feedback. Of the 6 cases found, 3 were correctly diagnosed with 2D ultrasound, while for the remaining 3 definitive diagnosis was obtained with the aid of 3D ultrasound. The sensitivity of 2D ultrasound was 50%, while the 3D ultrasound was 100%. Conclusions: The 2D ultrasound can be used today as a investigation of first level, especially in a sample of low-risk women. Combining ultrasound 2D + 3D is the one that guarantees the best results of sensitivity and specificity.