Analysis of fetal palate as a tool in prenatal ultrasound examination

Abstract

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 identification of the uvula and a normal uvula has a typical and resembling echographic pattern to the equal sign. Even tough, prenatal diagnosis of soft palate cleft is a real challenge, with low detection rate due to difficulty of its visualization during routine examination, and even if suspected, diagnostic accuracy is low.