Ebook Obstetric imaging: Fetal diagnosis and care - Part 2
➤ Gửi thông báo lỗi ⚠️ Báo cáo tài liệu vi phạmNội dung chi tiết: Ebook Obstetric imaging: Fetal diagnosis and care - Part 2
Ebook Obstetric imaging: Fetal diagnosis and care - Part 2
Head and NeckSECTION ONEFacial AnomaliesTo accost th« videos in this chapter, scan this OR code or visit E oxpertconsult.com iCleft Lip and PalateOLGA Ebook Obstetric imaging: Fetal diagnosis and care - Part 2 A GOMEZ I BIENVENIDO PUERTOIntroductionOrofacial clefts, which include cleft lip (CL), cleft lip and palate (CLP), and cleft palate alone (CP), include a range of disorders affecting the lips and oral cavity, and represent the most common craniofacial malformation identified in the newborn. They can Ebook Obstetric imaging: Fetal diagnosis and care - Part 2 occur as a part of a syndrome involving multiple organs or as isolated malformations.DisorderDEFINITIONOrofacial clefts represent all those defects iEbook Obstetric imaging: Fetal diagnosis and care - Part 2
nvolving the upper lip, with or without extension to the alveolar ridge or primary palate, and to the hard or secondary palate. Defects can also be clHead and NeckSECTION ONEFacial AnomaliesTo accost th« videos in this chapter, scan this OR code or visit E oxpertconsult.com iCleft Lip and PalateOLGA Ebook Obstetric imaging: Fetal diagnosis and care - Part 2 e risk of associated anomalies and postnatal outcome.PREVALENCE AND EPIDEMIOLOGYOrofacial clefts arise in about 1:700 to 1:1000 live births, with ethnic and geographic differences; the prevalence is lowest in African Americans, intermediate in Caucasians, and highest in Native Americans and Asians. Ebook Obstetric imaging: Fetal diagnosis and care - Part 2 The prevalence varies for the type of orofacial cleft: 3.4:10,000 to 22.0:10,000 births for CLand CLP and 1.3:10,000 to 25.3:10,000 births for isolateEbook Obstetric imaging: Fetal diagnosis and care - Part 2
d CP.1 CLand CLP arc listed as a feature in more than 200 and 400 genetic syndromes, respectively. Approximately 15% to 45% arc associated with other Head and NeckSECTION ONEFacial AnomaliesTo accost th« videos in this chapter, scan this OR code or visit E oxpertconsult.com iCleft Lip and PalateOLGA Ebook Obstetric imaging: Fetal diagnosis and care - Part 2 ial. Epidemiologic and experimental data suggest an influence of environmentalrisk factors such as maternal exposure to tobacco smoke, alcohol, poor nutrition, viral infection, medicinal drugs, and teratogens in early pregnancy. This is in line with the finding that planned pregnancies have lower ri Ebook Obstetric imaging: Fetal diagnosis and care - Part 2 sks of these defects.1Because the lip and primary palate have distinct development origins from the secondary palate, orofacial clefts can be subdividEbook Obstetric imaging: Fetal diagnosis and care - Part 2
ed into different types (Figs. 65.1-65.5):1Cleft lip without cleft palate (CL): 25% of orofacial clefts. Only the lip is Literally affected ami the deHead and NeckSECTION ONEFacial AnomaliesTo accost th« videos in this chapter, scan this OR code or visit E oxpertconsult.com iCleft Lip and PalateOLGA Ebook Obstetric imaging: Fetal diagnosis and care - Part 2 efect that can be unilateral or bilateral.3Isolated cleft palate (CP): 25% of orofacial clefts. Only the secondary palate is affected. This form is very seldom diagnosed prcnatally.4Median cleft lip and palate (MCLP): less than 1% of all orofacial clefts. It is distinguished etiologically from later Ebook Obstetric imaging: Fetal diagnosis and care - Part 2 al CL and/or CLP, since it could be considered a midline defect. It is more often associated with other brain and facial midlineFig. 65.1 Scheme of noEbook Obstetric imaging: Fetal diagnosis and care - Part 2
rmal ips ard palate. (Modified from Kernphan diagram).311312 PART 8 Head and Neck • SECTION ONE Fadal AnomaliesFig. 65.2 Scheme of unilateral and bilaHead and NeckSECTION ONEFacial AnomaliesTo accost th« videos in this chapter, scan this OR code or visit E oxpertconsult.com iCleft Lip and PalateOLGA Ebook Obstetric imaging: Fetal diagnosis and care - Part 2 the central part of the upper lip and palate.Fig. 65.3 Scheme of ur lateral and bilateral deft lip and palate (CLP) The primary palate is involved and the defect can c* cannot extend to the secondary palateFig. 65.4 Scheme of deft palate (CP) alone The lips and the primary palate are normal, and th Ebook Obstetric imaging: Fetal diagnosis and care - Part 2 ere is a defect in the hard palate that can affect only the most posterior part of itanomalies, and the risk of chromosomal anomalies is very high.MANEbook Obstetric imaging: Fetal diagnosis and care - Part 2
IFESTATIONS OF DISEASEClinical PresentationUnilateral forms arc more common than the bilateral forms (75% and 25%, respectively). The palate is affectHead and NeckSECTION ONEFacial AnomaliesTo accost th« videos in this chapter, scan this OR code or visit E oxpertconsult.com iCleft Lip and PalateOLGA Ebook Obstetric imaging: Fetal diagnosis and care - Part 2 ith other anomalies. The risk of chromosomal abnormalities is higher in bilateral forms of CLP, in isolated CP, and in those cases associated with other anomalies. Around 2% to 7% of the orofacial clefts can be associated with a genetic syndrome. ’■*The prognosis of orofacial clefts depends on its e Ebook Obstetric imaging: Fetal diagnosis and care - Part 2 xtension (involvement of palate) and its association with other anomalies. The effects of orofacial clefts on speech, hearing, appearance, and psycholEbook Obstetric imaging: Fetal diagnosis and care - Part 2
ogy can lead to long-lasting adverse outcomes for health and social integration. Typically, affected children need multidisciplinary care from birth tHead and NeckSECTION ONEFacial AnomaliesTo accost th« videos in this chapter, scan this OR code or visit E oxpertconsult.com iCleft Lip and PalateOLGA Ebook Obstetric imaging: Fetal diagnosis and care - Part 2 tissues of the fetal face arc visualized sonographically, at 13-14 weeks by transabdominal ultrasound (US) and somewhat earlier by transvaginal US.7* The diagnosis can be made using different views of the lower part of the face (Fig. 65.6), showing the interruption or discontinuity at the lip and/or Ebook Obstetric imaging: Fetal diagnosis and care - Part 2 palate. The oblique view of the mouth is essential for the diagnosis and to determine whether the defect is unilateral or bilateral. The axial view aEbook Obstetric imaging: Fetal diagnosis and care - Part 2
t the level of the upper maxilla will help determine the integrity or involvement of the anterior palate (Figs. 65.7 and 65,8). If CL is not associateHead and NeckSECTION ONEFacial AnomaliesTo accost th« videos in this chapter, scan this OR code or visit E oxpertconsult.com iCleft Lip and PalateOLGA Ebook Obstetric imaging: Fetal diagnosis and care - Part 2 n abnormal communication between the oral and nasal cavities can be seen. It should be noted that the midiinc sagittal view appears normal in unilateral CL and CLP, since the defect lies in another plane. Bilateral CLP presents a characteristic appearance, with midline protuberance of soft tissue ha Ebook Obstetric imaging: Fetal diagnosis and care - Part 2 nging from the philtrum (Fig. 65.9).*Several authors have suggested the utility of color Doppler to demonstrate the passage of amniotic flow through tEbook Obstetric imaging: Fetal diagnosis and care - Part 2
he palate during fetal swallowing (Fig. 65.10).Head and NeckSECTION ONEFacial AnomaliesTo accost th« videos in this chapter, scan this OR code or visit E oxpertconsult.com iCleft Lip and PalateOLGAHead and NeckSECTION ONEFacial AnomaliesTo accost th« videos in this chapter, scan this OR code or visit E oxpertconsult.com iCleft Lip and PalateOLGAGọi ngay
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