Improvement in early detection of orofacial clefts using the axial view of the maxilla

To evaluate the performance of the maxilla in the axial view in detection of orofacial clefts (OC) compared with the retronasal triangle (RNT) in the coronal view and palatine line in the sagittal view at the early stage of gestation.A total of 2982 fetuses (including 315 twins) were enrolled for the first-trimester screening in this prospective study. The maxilla in the axial view, palatine line in the sagittal view, and RNT in the coronal view were scanned by 2-dimensional ultrasound.Excluded 103 cases lost to follow-up, 2879 fetuses were analyzed in our study. Obtaining rates of the satisfactory image of the maxilla in the axial view, RNT in the coronal view, and palatine line in the sagittal view were 95.2%, 93.8%, and 98.2% respectively. Abnormal axial view of the maxilla, coronal view of the RNT, and sagittal view of the palatine line were observed in 100% (8/8), 75% (6/8), and 50% (4/8) of the CLP cases respectively.The study demonstrates that using the axial view of maxilla in the diagnosis of OC is feasible and improved the detection of OC compared with the sagittal view of the palatine line and coronal view of the RNT in the first trimester.