Donald School Journal of Ultrasound in Obstetrics and Gynecology

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VOLUME 13 , ISSUE 1 ( January-March, 2019 ) > List of Articles


Anomalies of the Fetal Face

Eberhard Merz, S Pashaj

Keywords : Congenital anomalies, Fetal face, Three-/Fourdimensional ultrasonography

Citation Information : Merz E, Pashaj S. Anomalies of the Fetal Face. Donald School J Ultrasound Obstet Gynecol 2019; 13 (1):34-40.

DOI: 10.5005/jp-journals-10009-1583

License: CC BY-NC 4.0

Published Online: 01-04-2019

Copyright Statement:  Copyright © 2019; The Author(s).


Visualization of the fetal face with three- and four-dimensional (3D/4D) ultrasound is a unique experience for both, the parents-to-be and the operator. While the future parents are primarily interested in seeing the surface of the fetal face and facial movements, the operator uses the different display modes for a precise fetal malformation check. The multiplanar mode with a simultaneous display of the three perpendicular planes allows an accurate demonstration of a normal or an abnormal fetal profile. Even if an image of the fetal face is acquired in an oblique position, the stored volume can be rotated by the rotational controls in all three directions, until the face is seen precisely in the median plane. The different surface modes enable the operator to detect abnormal protuberant structures or surface defects, while the transparent mode (maximum mode) reveals ossification defects. During a targeted ultrasound examination of the fetal face, five different regions have to be assessed: the forehead, orbits and eyes, nose, mouth, and chin. With 3D ultrasound the following fetal anomalies can be detected: anomalies including the forehead (anencephaly, protuberant forehead, abnormal metopic suture, frontal encephalocele/meningocele), anomalies of the orbits and the eyes (orbital hypoplasia/ microphthalmia, hypertelorism, hypotelorism, cataract, nasolacrimal cyst/dacryocystocele, cyclopia/proboscis), abnormalities of the nose (flat nose, absent nasal bone), abnormalities of the mouth (cleft lip/cleft palate, epignathus, macroglossia, chin anomaly (retrognathia/micrognathia). 3D ultrasonography allows a comprehensive evaluation of the fetal face with different display modes. In contrast to 2D ultrasound, 3D ultrasound enables a detailed demonstration of the soft tissue of the fetal face and thus contributes to a better understanding of the malformation by both the physician and the future parents.

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