OP09.06: Ultrasonographic evaluation of prenatal fetal facial anatomy: prenatal ultrasonographic evaluation of fetal facial anatomy and fetal facial malformations

To review the ultrasonographic evaluation of fetal facial anatomy and malformations in prenatal diagnosis. 4200 successive prenatal ultrasonographic scans made at gestational age 14–40 weeks, from August 2000 through June 2002, comprised the present review. Routine coronal, sagittal and transverse planes were applied to scan the fetus facial structures after the fetal position had been confirmed and/or adjusted. Superficial facial anatomic structures as well as the deep bony structures of the fetal faces were clearly displayed and correctly recognized on the three routine planes in 4184 cases (99.62%), but not the palate. Seventy-eight facial malformations of 29 fetuses were correctly diagnosed, whereas nine malformations of seven fetuses were missed, and two fetuses with suspected cleft palate were normal after delivery. The diagnoses were confirmed after subsequent labor or induced labor. The total detection rate reached 89.66%. The false negative rate was 10.34%, and the false positive rate, 0.05%. The sensitivity, specificity, accuracy, positive and negative predictive values were 85.29%, 99.95%, 99.83%, 93.50%, and 99.88% respectively. The majority of fetal facial superficial and deep structures are clearly demonstrated on prenatal ultrasonic imaging on the three routine scanning planes. Prenatal ultrasonographic evaluation of the fetal face is a reliable and accurate diagnostic modality as long as operators are skilled.