Prenatal assessment of the normal fetal soft palate by three‐dimensional ultrasound examination: is there an objective technique? (original) (raw)
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Analysis of fetal palate as a tool in prenatal ultrasound examination
Romanian Journal of Stomatology
Prenatal ultrasound examination should take place between 18 and 20 week of gestation and is important for early detection of fetal anomalies such as the facial malformations. One important anatomic element is the palate that raises echographic technical difficulties such as the shadowing by facial bones and, especially, by the superior alveolar ridge, the fetal prone position and its localization, respectively, profoundly, inside of fetal head or anatomic obstacles such as the fetal tongue, so new echographic examination techniques are being under evaluation. The prenatal detection rate of fetal cleft palate remains low, so various methods of examination are being proposed. The ultrasound assessment of the fetal face is made by 2D ultrasound, technique completed by 3D ultrasound, which includes the evaluation in both axial and coronal planes, with the uvula being analyzed in two types of section, transversal and sagittal. In the latter to epiglottis is a landmark that confirms the ...
Prenatal Diagnosis, 2013
The aim of this research was to evaluate the ability of three-dimensional (3D) ultrasound for demonstrating the palate of fetuses at high risk for cleft palate. Method Fifty-seven fetuses at high risk for cleft palate were referred for specialist ultrasound at 12-40 weeks' gestation. A detailed assessment of palate was made using both two-dimensional and 3D ultrasounds on the axial plane. Antenatal diagnoses were compared with postnatal findings. Results Cleft palate was suspected in 13 (22.8%); a normal palate was demonstrated in 38 (67%), and in six (10.2%), the palate view could not be obtained. Mean gestational age at the first visit was 27 weeks 6 days (range of 12-40 weeks 3 days). Examination after delivery revealed that one of the 38 fetuses with presumed normal palate had a cleft hard palate, and one had a cleft soft palate (false negative 5%). Among the 13 fetuses with suspected cleft palate, three had an intact palate (false-positive 23%). Sensitivity, specificity, positive predictive value, and negative predictive value of detection of palatal clefts were 71.4%, 91.9%, 62.5%, and 94.4%, respectively. Conclusion Using 3D technology, we diagnosed a cleft palate in 83% of high-risk cases, with 5% false negative. 3D technology might produce some technical artifacts resulting in a 23% false-positive rate.
Sonographic assessment of normal fetal palate using three‐dimensional imaging: a new technique
Ultrasound in Obstetrics & Gynecology, 2007
ObjectivesThe aim of this study was to describe a novel three‐dimensional (3D) ultrasound rendering technique to examine the normal fetal posterior palate and to assess its correspondence with the real fetal anatomy.MethodsA prospective longitudinal study was conducted from January to October 2005 and included 100 fetuses in a low‐risk population. Fetal ultrasound examinations were performed at 17, 22, 27 and 32 weeks' gestation to determine the normal 3D ultrasound view of the fetal palate at different gestational ages. The ultrasound scans were performed using the strict anterior axial plane of the starting reconstruction volume and the underside 3D view of the fetal palate. The 3D view of the fetal palate was compared with the normal anatomical view of the fetal palate obtained by surgical fetopathological examination of fetuses at the same gestational ages. The sonographic visualization rates of seven defined anatomical landmarks of the fetal palate were computed for each ge...
Analysis of Fetal Palate to Assist Pre-natal Ultrasound
JOURNAL OF CLINICAL AND DIAGNOSTIC RESEARCH, 2016
Introduction: Cleft palate is one of the major facial congenital malformation in newborns. Pre-natal detection of this malformation is limited to detection of clefting of hard palate but isolated soft palate clefting still remains challenge for sonologists. As Indian literature is limited present study was attempted to provide dimensions and position of fetal palate by digitized images. Aim: To study dimensions, position and differences in parameters between second and third trimester fetuses.
First-Trimester Assessment of the Fetal Palate
Journal of Ultrasound in Medicine, 2012
A Novel Application of the Volume NT Algorithm ith the widespread incorporation of first-trimester sonographic screening for aneuploidy and the improving resolution of ultrasound equipment, it has become evident that the assessment of the fetal anatomy and the diagnosis of an increasing number of fetal anomalies are currently possible in early gestation. Cleft lip and palate, with a reported incidence of 1 per 800 to 1000 deliveries, 1 is one of the most common malformations that can be detected prenatally, which has led to the recommendation of a routine examination of the upper lip at the time of the second-trimester anatomy scan. 2 However, the systematic evaluation of the fetal secondary palate with conventional 2-dimensional sonographic technology is technically difficult and therefore not included in the guidelines for routine prenatal sonographic examinations. 3 The first-trimester diagnosis of cleft lip and palate has been rarely reported in the literature, 4,5 mainly due to the poor familiarity with the early sonographic features associated with this condition and the lack of an established technique for evaluation. We recently described the retronasal triangle view, which simultaneously captures the alveolar ridge and the frontal processes of the maxilla in a coronal plane of the face, as an important landmark to facilitate the evaluation of the primary palate in the first trimester of pregnancy. 6 We have also noted the possibility of digital navigation through the secondary
Surgical and Radiologic Anatomy, 2007
Objective The objective of this case report is to evaluate the faculty of a recently described original three-dimensional ultrasound technique to detect pathological processes of the fetal palate. Method The palate of the fetus of a patient with a personal history of isolated incomplete cleft palate is evaluated by three-dimensional ultrasound at 34 weeks of gestation. The postnatal Wndings are compared to the prenatal investigation. Result The used three-dimensional ultrasound technique provides selective visualization of the total hard palate which permits the prenatal diagnosis and multidisciplinary approach of an incomplete cleft palate. Conclusion These prenatal Wndings might encourage further studies to conWrm the value of this recently described innovative technique in the diagnosis and surgical prenatal counselling of fetal cleft palate.
Ultrasound antenatal diagnosis of cleft palate by a new technique: the 3D ?reverse face? view
Ultrasound in Obstetrics and Gynecology, 2005
Objective To assess the clinical value of a novel threedimensional (3D) ultrasound technique, the reverse face view (3D RF view), in the antenatal categorization of facial clefting and in particular clefting of the hard palate. Methods Eight cases of suspected orofacial clefting were examined by 3D surface rendering. The fetal lips and alveolar ridge were examined in the frontal plane and the face was then rotated through 180 • on the vertical axis to examine the secondary palate by the 3D RF view. Results In each case described, we were able to visualize the fetal face, lips and palate and make an antenatal diagnosis as to whether the palate was affected. In all cases, the antenatal diagnosis was subsequently confirmed. In one case with a left-sided cleft in the lips and alveolar ridge and an intact hard palate, the correct diagnosis was made but a cleft in the soft palate was missed. Conclusion Although clefts of the lips and alveolar ridge are readily diagnosed on high-quality antenatal ultrasound, visualization of the fetal palate using existing techniques is unreliable. In the patients described here, the 3D RF technique allowed relatively straightforward assessment of the fetal palate with a high degree of accuracy.