Nyberg D A, Sickler G K, Hegge F N, Kramer D J, Kropp R J
Department of Ultrasound, Swedish Hospital Medical Center, Seattle, Wash, USA.
Radiology. 1995 Jun;195(3):677-84. doi: 10.1148/radiology.195.3.7753993.
To develop a prenatal ultrasonographic (US) classification of cleft lip with or without cleft palate (CL-P) and correlate the classification with fetal outcome.
During a 5-year period (1988 to 1993), 65 fetuses with CL-P were identified with prenatal US at one of two referral centers for high-risk obstetric cases. Sonograms from each case were prospectively and retrospectively evaluated. Clefts were classified into one of five categories: type 1, cleft lip alone (n = 5); type 2, unilateral cleft lip and palate (n = 15); type 3, bilateral cleft lip and palate (n = 20); type 4, midline cleft lip and palate (n = 21); and type 5, facial defects associated with amniotic bands or limb-body-wall complex (n = 4).
The US classification correlated with severity of defect and fetal outcome. Type 4 and 5 clefts were universally associated with concurrent anomalies and a fetal outcome, type 1 clefts with a lower rate of anomalies (20%), and type 2 and 3 clefts with intermediate prognosis. Chromosome abnormalities also varied with the type of cleft as follows: type 1, 0%; type 2, 20%; type 3, 30%; type 4, 52%; and type 5, 0%.
Prenatal classification of fetal CL-P correlates with fetal outcome. This classification should help counseling and management.
制定一种唇裂伴或不伴腭裂（CL-P）的产前超声（US）分类方法，并将该分类与胎儿结局相关联。
在5年期间（1988年至1993年），在两个高危产科转诊中心之一通过产前超声识别出65例CL-P胎儿。对每个病例的超声图像进行前瞻性和回顾性评估。腭裂被分为五类之一：1型，单纯唇裂（n = 5）；2型，单侧唇腭裂（n = 15）；3型，双侧唇腭裂（n = 20）；4型，正中唇腭裂（n = 21）；5型，与羊膜带或肢体-体壁复合体相关的面部缺陷（n = 4）。
超声分类与缺陷严重程度和胎儿结局相关。4型和5型腭裂普遍伴有并发畸形和胎儿结局，1型腭裂畸形发生率较低（20%），2型和3型腭裂预后中等。染色体异常也因腭裂类型而异，如下：1型，0%；2型，20%；3型，30%；4型，52%；5型，0%。
胎儿CL-P的产前分类与胎儿结局相关。这种分类有助于咨询和管理。
