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http://dx.doi.org/10.5999/aps.2016.43.2.153

The Importance of Multidisciplinary Management during Prenatal Care for Cleft Lip and Palate  

Han, Hyun Ho (Department of Plastic and Reconstructive Surgery, College of Medicine, The Catholic University of Korea)
Choi, Eun Jeong (Department of Plastic and Reconstructive Surgery, College of Medicine, The Catholic University of Korea)
Kim, Ji Min (Department of Plastic and Reconstructive Surgery, College of Medicine, The Catholic University of Korea)
Shin, Jong Chul (Department of Obstetrics and Gynecology, College of Medicine, The Catholic University of Korea)
Rhie, Jong Won (Department of Plastic and Reconstructive Surgery, College of Medicine, The Catholic University of Korea)
Publication Information
Archives of Plastic Surgery / v.43, no.2, 2016 , pp. 153-159 More about this Journal
Abstract
Background The prenatal ultrasound detection of cleft lip with or without cleft palate (CL/P) and its continuous management in the prenatal, perinatal, and postnatal periods using a multidisciplinary team approach can be beneficial for parents and their infants. In this report, we share our experiences with the prenatal detection of CL/P and the multidisciplinary management of this malformation in our institution's Congenital Disease Center. Methods The multidisciplinary team of the Congenital Disease Center for mothers of children with CL/P is composed of obstetricians, plastic and reconstructive surgeons, pediatricians, and psychiatrists. A total of 11 fetuses were diagnosed with CL/P from March 2009 to December 2013, and their mothers were referred to the Congenital Disease Center of our hospital. When CL/P is suspected in the prenatal ultrasound screening examination, the pregnant woman is referred to our center for further evaluation. Results The abortion rate was 28% (3/11). The concordance rate of the sonographic and final diagnoses was 100%. Ten women (91%) reported that they were satisfied with the multidisciplinary management in our center. Conclusions Although a child with a birth defect is unlikely to be received well, the women whose fetuses were diagnosed with CL/P on prenatal ultrasound screening and who underwent multidisciplinary team management were more likely to decide to continue their pregnancy.
Keywords
Cleft lip; Cleft palate; Craniofacial abnormalities; Ultrasonography; Interdisciplinary communication;
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Times Cited By KSCI : 1  (Citation Analysis)
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1 Blumenfeld Z, Blumenfeld I, Bronshtein M. The early prenatal diagnosis of cleft lip and the decision-making process. Cleft Palate Craniofac J 1999;36:105-7.   DOI
2 Wilhelm L, Borgers H. The 'equals sign': a novel marker in the diagnosis of fetal isolated cleft palate. Ultrasound Obstet Gynecol 2010;36:439-44.   DOI
3 Kim DW, Chung SW, Jung HD, et al. Prenatal ultrasonographic diagnosis of cleft lip with or without cleft palate; pitfalls and considerations. Maxillofac Plast Reconstr Surg 2015;37: 24.   DOI
4 Abramowicz S, Cooper ME, Bardi K, et al. Demographic and prenatal factors of patients with cleft lip and cleft palate: a pilot study. J Am Dent Assoc 2003;134:1371-6.   DOI
5 Ministry of Health and Welfare. The necessity for reinforcement of guarantee of insurance for the surgery of cleft lip and palate [gusungugaeyeol susul bojangseongganghwa pilyo] [Internet]. Sejong: Ministry of Health and Welfare. 2013 [cited 2016 Feb 1]. Available from: http://stat.mw.go.kr/front/notice/statPressReleaseView.jsp?menuId=31&bbsSeq=4&nttSeq=20541&nPage=1&searchKey=&searchWord=&sttsDataSeq=.
6 Sohan K, Freer M, Mercer N, et al. Prenatal detection of facial clefts. Fetal Diagn Ther 2001;16:196-9.   DOI
7 Cash C, Set P, Coleman N. The accuracy of antenatal ultrasound in the detection of facial clefts in a low-risk screening population. Ultrasound Obstet Gynecol 2001;18:432-6.   DOI
8 Moss A. Controversies in cleft lip and palate management. Ultrasound Obstet Gynecol 2001;18:420-1.   DOI
9 Christ JE, Meininger MG. Ultrasound diagnosis of cleft lip and cleft palate before birth. Plast Reconstr Surg 1981;68: 854-9.   DOI
10 Maarse W, Pistorius LR, Van Eeten WK, et al. Prenatal ultrasound screening for orofacial clefts. Ultrasound Obstet Gynecol 2011;38:434-9.   DOI
11 Rotten D, Levaillant JM. Two- and three-dimensional sonographic assessment of the fetal face. 2. Analysis of cleft lip, alveolus and palate. Ultrasound Obstet Gynecol 2004;24:402-11.   DOI
12 Nyberg DA, Sickler GK, Hegge FN, et al. Fetal cleft lip with and without cleft palate: US classification and correlation with outcome. Radiology 1995;195:677-84.   DOI
13 Davalbhakta A, Hall PN. The impact of antenatal diagnosis on the effectiveness and timing of counselling for cleft lip and palate. Br J Plast Surg 2000;53:298-301.   DOI
14 Ministry of Health and Welfare. The research on the actual condition of artificial abortion and establishment of comprehensive countermeasures [ingongimsinjungjeol siltaejosa mich jonghabdaechaegsulib], 2005 [Internet]. Sejong: Ministry of Health and Welfare. 2008 [cited 2016 Feb 1]. Available from: http://stat.mw.go.kr/front/statData/publicationView.jsp?menuId=47&bbsSeq=13&nttSeq=10104&searchKey=&searchWord=&nPage=7.
15 Nusbaum R, Grubs RE, Losee JE, et al. A qualitative description of receiving a diagnosis of clefting in the prenatal or postnatal period. J Genet Couns 2008;17:336-50.   DOI
16 Maarse W, Berge SJ, Pistorius L, et al. Diagnostic accuracy of transabdominal ultrasound in detecting prenatal cleft lip and palate: a systematic review. Ultrasound Obstet Gynecol 2010; 35:495-502.   DOI
17 Lippman A. Embodied Knowledge and Making Sense of Prenatal Diagnosis. J Genet Couns 1999;8:255-74.   DOI
18 Hulnick SJ. Ultrasound diagnosis of clefts. Plast Reconstr Surg 1982;70:118-9.
19 Hallock G. In defense of ultrasound diagnosis of cleft lips in utero. Plast Reconstr Surg 1983;71:443.
20 Matthews MS, Cohen M, Viglione M, et al. Prenatal counseling for cleft lip and palate. Plast Reconstr Surg 1998;101: 1-5.   DOI
21 Duboys EB. Prenatal counseling for cleft lip and palate. Plast Reconstr Surg 1998;102:278.
22 Bronshtein M, Blumenfeld I, Blumenfeld Z. Early prenatal diagnosis of cleft lip and its potential impact on the number of babies with cleft lip. Br J Oral Maxillofac Surg 1996;34: 486-7.   DOI