2007•Ultrasound in Obstetrics and GynecologyRequires access
P40.08: Posterior wall of the fetal palate: is it a reliable sign applicable in routine?
J. E. Develay‐Morice, Gauthier Rathat, Médéric Hoffet, P. Marès, N. Frandji‐Barbier, Catherine Fredouille, M. Bigorre, Pedro García-Alonso Montoya
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Abstract
New publications are on the way to say that cleft palate can be studied with ultrasound, but lets us think it is not accessible in routine, and only with 3D. Our experience lets us think the method we applied since 2002 is applicable in routine, without loss of time and reliable for osseous palate pathology. We described our method based on the visualization of the posterior wall of the osseous palate applied since 2002 on every fetus from 18 to 35 weeks (more than 8000 patients), and earlier now (sometimes 15 weeks). Recently we registered the time to get the posterior wall on 200 fetuses from the last scan (generally the inter orbital scan). Two non-experimented practitioners had 1 minute to obtain it. We also studied the reliability since 2002. The visualization of the posterior wall was obtained in all cases easily, in less than 20 seconds in more than 95% of the cases, generally inferior at 10 sec. The learning of this method was considered as successful because after 20 patients, the time to get the scan was about the same as the experimented practitioner. Based on the normal visualization of the posterior wall since 2002 we did not have any false negative or false positive on the integrity of the osseous palate. Based on this scan, we could also describe cleft, short and ogival palate. All these findings were confirmed after birth. We sometimes used 3D ‘thick view’, as it is easy to get when we have the posterior wall (generally less than 10 sec.) giving the whole palate on the same scan, but it did not change the diagnosis. This study demonstrates that the visualization of the posterior wall of the osseous palate is the key of the osseous palate. It's visualisation is possible in routine because it is easy to learn and to realise, without loss of time, and very reliable. This method we applied in routine since 2002 has demonstrated it's utility, reassuring the medical team and the parents' fears about the osseous cleft palate.