Fetal Cleft Lip and Palate

Fetal cleft lip and cleft palate are among the most common craniofacial anomalies, affecting approximately 1 in 1,000 live births worldwide. Cleft lip/cleft palate is caused by a combination of genetic and environmental factors and requires prompt diagnosis and lifelong multidisciplinary care for adequate treatment of anatomic and psychosocial challenges that extend well beyond surgical procedures in infancy. Cleft lip/cleft palate is a complex anomaly present from the first trimester onward that has prenatal and postnatal considerations. Diagnosis of cleft lip/cleft palate is most common in the second trimester through ultrasound visualization of the anatomic defect. However, characterization of the defect may be further performed in the third trimester, possibly with the adjunct of magnetic resonance imaging. Prenatal management depends on the cause, genetic association, or additional anatomic abnormalities that may dictate specific timing and location of delivery. Multidisciplinary management involves perinatology, genetic counseling, orofacial surgery, and lactation specialists and speech and language therapists among experts from other specialties for comprehensive treatment. In this narrative review of cleft lip/cleft palate, the anatomic characteristics, imaging findings, causes, genetic associations, and management are discussed.