Nyberg et al used fetal ultrasound to classify cleft lip with or without cleft palate. The authors are from Swedish Hospital Medical Center in Seattle, Washington, and Emanuel Hospital in Portland, Oregon.
Parameters:
(1) cleft lip
(2) cleft palate
(3) premaxillary protrusions
(4) amniotic band or limb-body-wall (LBW) complex
Cleft Lip
Cleft Palate
Premaxillary Protrusion
Amniotic Band or LBW Complex
Type
absent
absent
absent
absent
normal
unilateral
absent
absent
absent
1
unilateral
present
absent
absent
2
bilateral
present
present
absent
3a
bilateral
present
absent
absent
3b
midline
present
NA
absent
4
present
NA
NA
present
5
where:
• The limb-body-wall complex = exencephaly or calvareal defect, defect in body wall, often scoliosis, and intra-amniotic bands (page 678).
• Premaxillary protrusion occurs when there is anterior growth and displacement of the maxilla. This results in an intermaxillary echogenic area or soft tissue mass protruding at the upper lip on ultrasound.
Types 2, 3 and 4 are associated with a high risk for chromosome abnormalities (page 683).
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