Facial Clefts


Figer-1

๐Ÿ“„ Report Sample Line- Median cleft (During First Trimester / NT Screening)
A median facial cleft is noted, characterized by abnormal discontinuity of the midline upper lip and/or premaxillary region on coronal facial view. Nasal bone visualization may be suboptimal


Conclussion: ๐Ÿ“‹ Findings are suggestive of a median facial cleft anomaly which may be associated with underlying syndromic or chromosomal abnormalities.
Recommendation: Recommend a targeted Level II anomaly scan, fetal echocardiography, and genetic counseling. Consider karyotyping and/or chromosomal microarray testing. 3D ultrasound and fetal MRI may aid in further anatomical assessment.

Figer-2

๐Ÿ“„ Report Sample Line- Unilateral (Upper) cleft lip (CL/±P) (During First Trimester / NT Screening)
Shows a unilateral upper cleft lip noted on coronal facial view — defect visualized on the [left/right] side of the upper lip with discontinuity in the soft tissue line.


Conclussion: ๐Ÿ“‹ Findings suggest the presence of a unilateral cleft lip. Detailed evaluation of the maxilla and palate is limited at this gestational age
Recommendation: Recommend follow-up with a targeted anomaly scan around 18–22 weeks for detailed assessment of the lip and palate. 3D/4D ultrasound and genetic counseling are advised

Figer-3

๐Ÿ“„ Report Sample Line- Unilateral (Lower) cleft lip (CL/±P) (During First Trimester / NT Screening)
shows a unilateral lower cleft lip identified on coronal facial view during NT screening. Defect noted on the [left/right] side of the lower lip, with possible involvement of the lower alveolar ridge.


Conclussion: ๐Ÿ“‹ Findings are suggestive of a unilateral lower cleft lip (CL)
Recommendation: Detailed follow-up with mid-trimester targeted anomaly scan and 3D facial imaging is recommended.

Figer-4

๐Ÿ“„ Report Sample Line- Bilateral cleft lip (CL/±P) (During First Trimester / NT Screening)
Bilateral discontinuity of the upper lip visualized on coronal facial views during first-trimester NT screening, suggestive of bilateral cleft lip.


Conclussion: ๐Ÿ“‹ onographic features are suspicious for bilateral cleft lip with possible extension to the alveolus and/or palate. Sonographic features are suspicious for bilateral cleft lip, with possible extension to the alveolus and/or palate.
Recommendation: Advise follow-up with a detailed second-trimester anomaly scan and 3D facial ultrasound to confirm the extent of the defect.
Note:-Palatal involvement (cleft lip with or without palate involvement – CL/±P) cannot be confidently assessed at this stage.



Bilingual Quiz - Facial Clefts

Note: Select English to answer in English, เคฏा เคนिंเคฆी เคšुเคจें เคคो เคช्เคฐเคถ्เคจों เค•े เค‰เคค्เคคเคฐ เคนिंเคฆी เคฎें เคฆीเคœिเค।

1. What are facial clefts? 1. เคซेเคธिเคฏเคฒ เค•्เคฒीเคซ़्เคŸ्เคธ เค•्เคฏा เคนैं?
A. Congenital gaps or malformations in the lip, alveolus, palate, or facial structures
B. Acquired facial scars only
C. Only ear deformities
D. Maternal facial injury
2. The two most common types of facial clefts are: 2. เคซेเคธिเคฏเคฒ เค•्เคฒीเคซ़्เคŸ्เคธ เค•े เคฆो เคธเคฌเคธे เค†เคฎ เคช्เคฐเค•ाเคฐ เค•ौเคจ เคธे เคนैं?
A. Cleft lip (with or without alveolus) and cleft palate
B. Orbital and scalp clefts only
C. Nasal bone absence only
D. Cleft foot only
3. Prenatal ultrasound suspicion of facial cleft is primarily raised by: 3. เค—เคฐ्เคญเค•ाเคฒीเคจ เค…เคฒ्เคŸ्เคฐाเคธाเค‰ंเคก เคชเคฐ เคซेเคธिเคฏเคฒ เค•्เคฒीเคซ़्เคŸ เค•ा เคธंเคฆेเคน เคฎुเค–्เคฏเคคः เค•िเคธเคธे เค‰เค เคคा เคนै?
A. Discontinuity or abnormal contour of the upper lip, visualized in coronal or sagittal face views
B. Only fetal foot position
C. Placental texture only
D. Maternal skin changes
4. Which associated findings should be checked when a facial cleft is detected prenatally? 4. เคœเคฌ เค—เคฐ्เคญเค•ाเคฒीเคจ เคฐूเคช เคธे เคซेเคธिเคฏเคฒ เค•्เคฒीเคซ़्เคŸ เคชाเคฏा เคœाเคคा เคนै เคคो เค•िเคจ เคœुเคก़ी เคนुเคˆ เค–ोเคœों เค•ी เคœाँเคš เค•เคฐเคจी เคšाเคนिเค?
A. Other structural anomalies (cardiac, CNS), polyhydramnios, and offer genetic testing as clefts can be syndromic
B. Only maternal glucose
C. Only fetal eye color
D. No further checks required
5. Which ultrasound plane is most helpful to evaluate the fetal lip? 5. เคญ्เคฐूเคฃ เค•ी เคนोंเค  เค•ा เคฎूเคฒ्เคฏांเค•เคจ เค•เคฐเคจे เค•े เคฒिเค เค•ौเคจ เคธा เค…เคฒ्เคŸ्เคฐाเคธाเค‰ंเคก เคช्เคฒेเคจ เคธเคฌเคธे เคธเคนाเคฏเค• เคนै?
A. Coronal view of the fetal face (true coronal) and sagittal profile for palate
B. Transverse abdomen only
C. Maternal pelvic view only
D. Fetal foot view
6. Cleft palate without cleft lip is harder to detect prenatally because: 6. เคนोंเค  เค•े เคฌिเคจा เค•्เคฒेเคซ เคชॅเคฒेเคŸ เค•ो เค—เคฐ्เคญ เคฎें เคชเค•เคก़เคจा เค•เค िเคจ เค•्เคฏों เคนै?
A. Palatal clefts may be subtle and require dedicated views or 3D imaging to visualize the secondary palate
B. It does not exist prenatally
C. Always obvious on routine scans
D. Only detectable postnatally by hearing test
7. Common syndromes associated with facial clefts include: 7. เคซेเคธिเคฏเคฒ เค•्เคฒीเคซ़्เคŸ्เคธ เคธे เคœुเคก़े เคธाเคฎाเคจ्เคฏ เคธिเคฃ्เคก्เคฐोเคฎ เค•ौเคจ เคธे เคนैं?
A. Pierre Robin sequence, Van der Woude syndrome, and chromosomal anomalies (eg trisomy 13)
B. Only maternal skin conditions
C. Only cardiac infections
D. No syndromic associations
8. Prenatal counseling for facial cleft should include: 8. เคซेเคธिเคฏเคฒ เค•्เคฒीเคซ़्เคŸ เค•े เคฒिเค เค—เคฐ्เคญเค•ाเคฒीเคจ เคชเคฐाเคฎเคฐ्เคถ เคฎें เค•्เคฏा เคถाเคฎिเคฒ เคนोเคจा เคšाเคนिเค?
A. Discuss likely postnatal repair needs, feeding challenges, possible airway issues, genetic implications, and referral to multidisciplinary team
B. Tell parents nothing can be done
C. Recommend immediate termination without discussion
D. Only advise on maternal diet
9. Which postnatal interventions are commonly needed for infants with cleft lip/palate? 9. เคนोंเค /เคคाเคฒु เค•े เค•्เคฒेเคซ เคตाเคฒे เคถिเคถुเค“ं เค•े เคฒिเค เคœเคจ्เคฎोเคชเคฐांเคค เค•ौเคจ เคธे เคนเคธ्เคคเค•्เคทेเคช เคธाเคฎाเคจ्เคฏเคคः เค†เคตเคถ्เคฏเค• เคนोเคคे เคนैं?
A. Surgical repair (lip and palate repair), feeding support (special bottles), speech therapy and dental/orthodontic care
B. Immediate cardiac transplant
C. No interventions ever
D. Only maternal antibiotics
10. If a suspected facial cleft is seen on ultrasound, the next imaging step to improve detection is often: 10. เคฏเคฆि เค…เคฒ्เคŸ्เคฐाเคธाเค‰ंเคก เคชเคฐ เคธंเคฆेเคนाเคธ्เคชเคฆ เคซेเคธिเคฏเคฒ เค•्เคฒीเคซ़्เคŸ เคฆेเค–ा เคœाเคคा เคนै, เคคो เคชเคนเคšाเคจ เคธुเคงाเคฐเคจे เค•े เคฒिเค เค…เค—เคฒा เค‡เคฎेเคœिंเค— เค•เคฆเคฎ เค…เค•्เคธเคฐ เค•्เคฏा เคนोเคคा เคนै?
A. Targeted high-resolution ultrasound with coronal/sagittal facial views and consider 3D ultrasound or fetal MRI for palate assessment
B. Maternal chest X-ray only
C. Fetal bone scan
D. No further imaging

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