Pregnancy with Facial Cleft: 20 Years of Experience at a Single Center.


Journal

The Israel Medical Association journal : IMAJ
ISSN: 1565-1088
Titre abrégé: Isr Med Assoc J
Pays: Israel
ID NLM: 100930740

Informations de publication

Date de publication:
Oct 2023
Historique:
medline: 23 10 2023
pubmed: 17 10 2023
entrez: 17 10 2023
Statut: ppublish

Résumé

Fetal facial clefts are among the most common congenital anomalies detected prenatally. This finding may lead to termination of pregnancy in some cases. To compare a cohort of fetuses with facial clefts in which the pregnancy was terminated to the cohort of cases that were born with facial clefts. To investigate risk factors for facial clefts. We conducted a retrospective chart review of all women with prenatal and postnatal diagnosis of facial cleft that were managed in our institute. A telephone questionnaire was conducted regarding a positive family history and/or genetic predisposition for facial clefts abnormalities. The final cohort consisted of two group. One group included 54 cases of termination of pregnancy (TOP) that were performed due to cleft lip (CL) or cleft palate (CLP); 27 women answered the telephone questionnaire. The second group comprised 99 women who delivered children with facial cleft during the same period; 60 answered the questionnaire. Only seven cases were diagnosed prenatal. Among the two groups, no correlation to family history was discovered. Of note, there was one case of three consecutive fetuses with CL in one woman, without any significant genetic findings. To the best of our knowledge, this is the first study to describe an anatomical malformation posing an ethical dilemma before TOP. Primary prevention with folic acid and early sonographic detection of CL/CLP with multidisciplinary consultation should be considered.

Sections du résumé

BACKGROUND BACKGROUND
Fetal facial clefts are among the most common congenital anomalies detected prenatally. This finding may lead to termination of pregnancy in some cases.
OBJECTIVES OBJECTIVE
To compare a cohort of fetuses with facial clefts in which the pregnancy was terminated to the cohort of cases that were born with facial clefts. To investigate risk factors for facial clefts.
METHODS METHODS
We conducted a retrospective chart review of all women with prenatal and postnatal diagnosis of facial cleft that were managed in our institute. A telephone questionnaire was conducted regarding a positive family history and/or genetic predisposition for facial clefts abnormalities.
RESULTS RESULTS
The final cohort consisted of two group. One group included 54 cases of termination of pregnancy (TOP) that were performed due to cleft lip (CL) or cleft palate (CLP); 27 women answered the telephone questionnaire. The second group comprised 99 women who delivered children with facial cleft during the same period; 60 answered the questionnaire. Only seven cases were diagnosed prenatal. Among the two groups, no correlation to family history was discovered. Of note, there was one case of three consecutive fetuses with CL in one woman, without any significant genetic findings.
CONCLUSIONS CONCLUSIONS
To the best of our knowledge, this is the first study to describe an anatomical malformation posing an ethical dilemma before TOP. Primary prevention with folic acid and early sonographic detection of CL/CLP with multidisciplinary consultation should be considered.

Identifiants

pubmed: 37846996

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

678-682

Auteurs

Marina Pekar-Zlotin (M)

Department of Obstetrics and Gynecology, Shamir Medical Center (Assaf Harofeh), Zerifin, Israel, affiliated with Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.

Natali Zilberman Sharon (N)

Department of Obstetrics and Gynecology, Shamir Medical Center (Assaf Harofeh), Zerifin, Israel, affiliated with Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.

Yaakov Melcer (Y)

Department of Obstetrics and Gynecology, Shamir Medical Center (Assaf Harofeh), Zerifin, Israel, affiliated with Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.

Yael Tal-Bliman (Y)

Department of Obstetrics and Gynecology, Shamir Medical Center (Assaf Harofeh), Zerifin, Israel, affiliated with Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.

Jodi Ezratty (J)

Department of Obstetrics and Gynecology, Shamir Medical Center (Assaf Harofeh), Zerifin, Israel, affiliated with Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.

Michal Feingold-Zadok (M)

Department of Obstetrics and Gynecology, Shamir Medical Center (Assaf Harofeh), Zerifin, Israel, affiliated with Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.

Ran Svirsky (R)

Department of Obstetrics and Gynecology, Shamir Medical Center (Assaf Harofeh), Zerifin, Israel, affiliated with Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.

Ron Maymon (R)

Department of Obstetrics and Gynecology, Shamir Medical Center (Assaf Harofeh), Zerifin, Israel, affiliated with Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.

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