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Fetal Medicine Posters
Antenatal detection of facial clefts: is the FASP target achievable?
  1. J Budd1,
  2. G Abou Elsenoun3,
  3. HA Mousa2,
  4. ES Draper1
  1. 1East Midlands and South Yorkshire Congenital Anomalies Register, Dept. Health Sciences, University of Leicester, Leicester, United Kingdom
  2. 2Department of Obstetrics and Gynaecology, University Hospitals of Leicester Trust, Leicester, United Kingdom
  3. 3Department of Obstetrics and Gynaecology, Chesterfield & North Derbyshire Royal Hospital Trust, Chesterfield, United Kingdom

Abstract

Background In 2010 the NHS Fetal Anomaly Screening Programme issued national guidelines and standards concerning the 18+0–21+6 Fetal Anomaly Scan. Cleft Lip +/- Palate (CL+/-P) is one of eleven congenital anomalies now monitored nationally, with a target rate for antenatal diagnosis of 75%. Here we present antenatal detection rates for CL+/-P in the East Midlands and South Yorkshire Congenital Anomaly Register (EMSYCAR) between 2005-2010 and associated anomalies.

Methods All cases of oro-facial clefts, with dates of delivery between 01/01/200531/12/2010 were identified by EMSYCAR. Cases were coded using the ICD10 system, distinguishing between Q35 (CP), Q36 (CL) and Q37 (CL+P). Details of antenatal detection and associated anomalies were recorded.

Results There were 600 cases of oro-facial clefting reported (13.8/10,000 deliveries (95%ci, 12.7-14.9): 403 were cases of CL (n=134) or CL+P (n=269). This rate, 9.3/10,000 (95%ci, 8.4-10.2), is virtually identical to the EUROCAT surveillance system (9.36). 70% (95%ci, 65%-75%) of cases (283/403) were diagnosed antenatally. However, this figure was significantly lower for CLs (57%;95%ci,49%-66%) than forCL+P cases (76.5%;95%ci, 71%-82%).

Although antenatal detection rates are improving, from 66% (95%ci, 59%-73%) in 2005-2007 to 77% (95%ci, 68-80%) in 2008-2010, this was not quite statistically significant (p=0.07). There is also wide variation in detection rates between individual trusts (range 46%-100%) 76% of CL cases were isolated: 8.2% with chromosomal and 13.4% multiple aetiology. Rates for CL+P were 71.7%, 10.8% and 15.2%, respectively.

Conclusions The FASP target of 75% for CL+/-P is being achieved across EMSYCAR. Approximately one quarter of CL+/-P cases are associated with other anomalies.

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