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Diagnóstico Pré-Natal de Fenda Labial e Palatina: Experiência de 40 Casos Prenatal Diagnosis of Lip and Palate Cleft: Experience of 40 Cases

By Victor Bunduki, Rodrigo Ruano, Andréia David Sapienza, Beatriz Yae Hanaoka and Marcelo Zugaib

Abstract

Objetivos: avaliar casos de fenda facial fetal quanto ao tipo de lesão, associação com outras malformações e aneuploidias. Métodos: as fendas faciais foram estudadas quanto a idade materna e antecedentes, idade gestacional no diagnóstico, lado da lesão, tipo de lesão, presença de malformações associadas e/ou aneuploidias, mortalidade e seguimento pós-natal. Resultados: em 40 fetos com fenda, a lesão era labial pura em 18 casos (45%), labiopalatina em 19 (47,5%) e palatina em 3 (7,5%). Em 10 casos a fenda era isolada (25%), todas unilaterais. No grupo de malformações associadas, a aneuploidia esteve presente em 10/30 (33,3%). A lesão labiopalatina predominou neste grupo (18/30 - 60%), seguida por fenda bilateral (8/30 - 26,7%) e mediana (10/30 - 33,3%). Conclusões: as fendas faciais constituíram excelente marcador para malformações associadas e aneuploidias fetais. Casos de fendas faciais devem ser encaminhados para centros especializados para que se realizem adequados exames ultra-sonográfico e genético tecendo em seguida a conduta. O caráter isolado da fenda facial esteve associado a excelente prognóstico.<br>Purpose: to evaluate fetuses with facial cleft as to type of lesion, associated malformations and aneuploidies. Method: the following parameters were evaluated: maternal age and previous history, gestational age at diagnosis, lesion side, type of lesion, presence of associated malformations and aneuploidies, mortality rate and postnatal follow-up. Results: forty fetuses had facial cleft, 18 (45%) cases had cleft lip, 19 (47.5%) had cleft lip and palate, and 3 (7.5%) cases presented with cleft palate. Isolated facial cleft was observed in 10 fetuses (25%), all of them unilaterally located. Aneuploidies were identified in 10/30 (33.33%) of the patients with associated malformations. Cleft lip and palate was more often seen in this group (18/30 - 60%), followed by bilateral lesion (8/30 - 26.7%) and median cleft (10/30 - 33.3%). Conclusion: facial clefts are considered excellent signs for the presence of associated malformations and fetal aneuploidies. Fetuses with facial cleft must be referred to specialized centers in order to have specialized ultrasound and genetic analysis which can provide the best prenatal counseling for these cases. Isolated facial cleft was associated with very good prognosis

Topics: Fenda labial, Fenda palatina, Diagnóstico pré-natal, Malformações fetais, Cleft lip, Cleft palate, Prenatal diagnosis, Fetal malformations, Gynecology and obstetrics, RG1-991, Medicine, R, DOAJ:Gynecology and Obstetrics, DOAJ:Medicine (General), DOAJ:Health Sciences
Publisher: Federação Brasileira das Sociedades de Ginecologia e Obstetrícia
Year: 2001
DOI identifier: 10.1590/S0100-72032001000900003
OAI identifier: oai:doaj.org/article:31d9cadc61324572a10e222eebc780b2
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