First and Mid Trimester Ultrasound Diagnosis of Orofacial Clefts An Atlas and Guide

This book aims to highlight all the existing information available on first and mid-trimester imaging of palate in prenatal ultrasound and to develop a methodical approach in imaging the palate. As formation of the palate is completed by 11 weeks of gestation and as there are no evolving changes in palatine anatomy at the mid-trimester, diagnosis of palatine clefts can now completely be shifted to late first-trimester. First-trimester evaluation of palate is now gaining importance and a number of techniques have currently been proposed by different authors.

This book covers the existing literature and recent 2D and 3D techniques in evaluating palate and helps in the early detection of palatine clefts in the first trimester. Orofacial clefting is one of the most common birth defects and the burden of it in developing countries is substantial. This book helps in improving the counseling options for the obstetrician and the couple early in gestation. It includes 2D and 3D images of various types of palatine clefts and the nuances in imaging the secondary palate extensively. 3D images of the palate also help the multi-disciplinary team especially the maxillofacial surgeons involved in managing orofacial clefts. It also includes videos for easy understanding.

This book is a ready reckoner for the imaging specialists and students /trainees involved in prenatal diagnosis. It provides essential information in diagnosing orofacial cleft both to the novice and to the skilled professionals involved in the field of diagnostic fetal ultrasound.  

Orofacial clefting.- Embryology.- Classification of clefts / Nomenclature.- Sonoanatomy of palate at 11-14 weeks.- Described markers to detect first trimester palatine clefts.- Multiplanar imaging at 11-14 week.- Defining type and extent of cleft in first trimester.- Sonoanatomy of palate at 20 weeks.- 3D techniques to evaluate palate in second trimester.- Evaluation of facial cleft in second trimester.- Isolated cleft of palate.- Syndromes and associations [micrognathia].- MRI in orofacial cleft.

Dr. Lakshmy Ravi Selvaraj is Consultant and Director of Shri Lakshmi Clinic and Scan Centre, Krishnagiri, Tamil Nadu. She is the best outgoing student of 1993 Batch and gold medalist at Government Mohan Kumaramangalam Medical College, Salem. She is one of the leading pioneers in the implementation of prenatal screening in a rural setup. She is an invited speaker in many national and international conferences. She has done exemplary work in imaging the fetal palate in first trimester and have delivered many lectures on the fetal palate. She has also presented papers including the “superimposed line sign”: a novel marker in early diagnosis of secondary cleft palate in ISUOG’s 2018 World Congress on ultrasound in Obstetrics and Gynecology held at Singapore. In the last few years, Dr. Lakshmy SR has authored numerous insightful papers in the field of prenatal ultrasound diagnosis.

Dr Thasleem Ziyaullah graduated from PSG Institute of Medical Science and Research, Coimbatore and obtained her Masters in Obstetrics and Gynaecology from Vinayaka Missions Kirupananda Variyar Medical College and Hospital, Salem. She is university topper and gold medalist in her post graduation. She is a Consultant at Shri Lakshmi Clinic and Scan Centre and has co-authored more than fifteen mutual publications with Dr. Lakshmy SR. Her special areas of interest are first trimester evaluation of the fetus, screening for PE and FGR and infertility.