The impact of antenatal diagnosis on the effectiveness and timing of counselling for cleft lip and palate

Birth of a cleft child is emotionally distressing to the parents. The oppor tunity for forewarning the parents is now possible with antenatal ultrasoun d diagnosis of the cleft. This has opened up a new chapter of antenatal cou nselling. We present a retrospective postal study of 124 primary cleft lip and/or palate repairs operated over the last 5 years. III our study 30% wer e diagnosed antenatally and received antenatal counselling, The rest receiv ed postnatal counselling. Of those who had an antenatal diagnosis 85% felt that the diagnosis prepared them psychologically for the birth of the cleft child. A total of 92% (n = 23) of parents who had antenatal as well as pos tnatal counselling, as compared with 71% (n = 46) of those counselled only postnatally, said the information given to them by the counselling cleft te am was detailed and satisfactory. The majority of those who felt counsellin g was confusing had only postnatal counselling. Of those who had antenatal diagnosis 92% said that they had never contemplated termination of pregnanc y. Only one parent had actually terminated her pregnancy due solely to the antenatal diagnosis of a bilateral cleft lip and palate. Our study has high lighted the importance of antenatal diagnosis of cleft and the importance o f antenatal counselling for the delivery of a cleft child to be a positive experience. (C) 2000 The British Association of Plastic Surgeons.