OP23.06: Prevalence, diagnosis and outcome of oral clefts in Singapore: a five‐year retrospective review

Abstract

Objectives: To assess the accuracy of antenatal diagnosis of oral clefts (isolated or associated clefts) and pregnancy outcomes in a tertiary referral centre, so as to provide a basis for prenatal counselling and prenatal invasive diagnostics. Methods: This was a retrospective review of cases with postnatal diagnosis of oral cleft from our hospital's database. Cases with estimated date of delivery between 1 January 2011 and 31 December 2015 were included. Results: During the study period, 78 cases of oral cleft were identified. 58 cases underwent screening at 18 to 23 weeks and detection rate was 93.1% (54/58). Prevalence in our local population is 13.6 per 10,000 (78/57,528) live births with a male to female ratio of 1.3 (41/32).Detection rate for isolated oral clefts was significantly higher compared to clefts associated with congenital anomalies (associated cleft) [100.0% (47/47) vs 63.6% (7/11); p=0.0003)]. While studies have demonstrated that chromosomal abnormalities were most frequently seen in associated clefts, we were unable to demonstrate a significant difference in our study (isolated cleft -95.8% (23/24) vs associated cleft -88.9% (8/9), p=1).Our results showed that fetuses with median clefts were more likely to have associated congenital anomalies compared to unilateral and bilateral clefts [50% (2/4), 27.4% (17/62),16.7% (2/12)].While the live-birth rates for fetuses with isolated or associated clefts was not statistically significant [66.7% (38/57) vs 90.5% (19/21), p=0.0695)], neonates with isolated cleft had a higher survival rate [isolated -100% (38/38), associated cleft -19.0% (4/19), p<0.0001]. Conclusions: Our study demonstrated prenatal detection and prevalence rates comparable to literature. We were unable to demonstrate a significant difference in detection of chromosomal abnormalities between the different types of oral clefts due to the small number of patients who underwent genetic analysis. Fetuses with median cleft were more likely to be associated with congenital anomalies. Neonates with isolated cleft had a higher survival rate. OP23.07Parental serum alkaline phosphatase activity as an auxiliary tool for prenatal diagnosis of hypophosphatasia