Diagnosis of fetal isolated cleft palate using assessment of the posterior hard palate angle.

OBJECTIVE

The study aims to evaluate the role of the posterior hard palate angle in the prenatal diagnosis of cleft palate.

STUDY DESIGN

Stored images of the axial transverse view of the fetal secondary palate, obtained at three-level obstetric ultrasounds, were used to evaluate the posterior border of the hard palate. The study population comprised 63 consecutive pregnancies of unaffected cases and 17 pregnancies suspected for a cleft palate without cleft lip, including 7 cases of cleft palate, 4 cases of high-arched palate, and 6 false-positive cases.

RESULTS

The posterior angle of the hard palate was significantly larger in the cleft palate group than in the healthy controls and false-positive cases: 227° (±51°) vs 160° (±16°), < 0.0001; and 173° ± 18°, < 0.0001, respectively. Regression analysis revealed that reflex angle remained an independent risk factor for cleft palate (odds ratio, 58.67 (95% confidence interval 10-341)). The sensitivity and specificity of the posterior angle assessment were 73% and 96%, respectively.

CONCLUSIONS

The posterior hard palate angle could be an ultrasound marker of cleft palate without a cleft lip.