PRENATAL-DIAGNOSIS OF CLEFT-LIP AND CLEFT -PALATE - IMPACT ON CURRENTMANAGEMENT - COMMENTS ON 7 YEARS OF EXPERIENCE

Clefts in the lip and palate are the most common of all congenital def ects of the face and generate severe parental distress, which may have repercussions on the child. Management requires the involvement from birth to completion of growth of a specialized, multidisciplinary, ped iatric team. An increasing number of facial clefts are being diagnosed prenatally upon ultrasonography. The cleft can involve the lip and/or hard and soft palates. Prenatal diagnosis of a facial cleft should le ad to investigations for a chromosomal abnormality and for other defec ts, especially of the brain. The diagnosis, prognosis, and management should then be discussed by a multidisciplinary team. When the cleft i s the only defect, the parents are advised to allow the pregnancy to b e carried to term. Based on seven years of experience, the authors hav e developed a strategy for the management of antenatally diagnosed fac ial clefts. Goals include helping the parents accept their infant's fa cial deformity and the burdensome treatment it requires, ensuring that birth occurs under optimal conditions, and minimizing the adverse psy chological consequences of the defect on the child.