DETECTION OF CLEFT-LIP BY EARLY 2ND-TRIMESTER TRANSVAGINAL SONOGRAPHY

Objective: To describe the detection of cleft lip in the early second trimester using transvaginal sonography. Methods: We analyzed retrospe ctively 14,988 ultrasound examinations conducted for fetal malformatio ns between 12-16 weeks' gestation. Seventy-five percent of the patient s were at low risk for fetal anomalies and 25% were at high risk.Resul ts: Eleven cases of fetal cleft lip with or without cleft palate were detected by transvaginal sonography among 14,988 fetuses (0.07%). In n ine cases, no risk factors for cleft lip or palate existed. In six cas es, the cleft lip represented an isolated malformation, with no other associated anomaly; in five of these six cases, the pregnancy was term inated. One additional ease of a small cleft lip was not detected, for a false-negative rate of 8%. Conclusions: The fetal lips can be scann ed by transvaginal sonography in the early second trimester, and fetal cleft lip can be detected in most cases. Early second-trimester detec tion of cleft lip by transvaginal sonography allows informed parental choice regarding continuing or terminating the affected pregnancy.