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Focus on Prenatal Detection of Micrognathia

Antonakopoulos, N; Bhide, A (2019) Focus on Prenatal Detection of Micrognathia. JOURNAL OF FETAL MEDICINE, 6 (3). pp. 107-112. ISSN 2348-1153 https://doi.org/10.1007/s40556-019-00210-0
SGUL Authors: Bhide, Amarnath

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Abstract

Fetal micrognathia involves abnormal or arrested development of the fetal mandible. Till recently, the prenatal diagnosis was subjective, based on the evaluation of the fetal profile and assessment of the relationship between the maxilla and the mandible. Recently objective sonographic methods have been utilized for diagnosing micrognathia such as the inferior facial angle, the jaw index, the frontal nasomental angle, the mandible width/maxilla width ratio and the mandibular length. Another useful sonographic sign, the mandibular gap in the retronasal triangle view, increases the accuracy of the diagnosis early in the first trimester. 3D sonographic views can add to the diagnosis and prenatal MRI is a useful adjunct to ultrasound in cases of limited acoustic window, maternal obesity, oligohydramnios and anterior spine position. The identification of micrognathia should prompt karyotyping and sonographic investigation for other abnormalities. The outcome of fetuses with this seemingly isolated finding is more guarded than one would intuitively believe, and the parents should be counseled accordingly. Postnatal complications including mild to severe upper airway obstruction leading to respiratory distress, feeding difficulties and mild to severe long-term developmental delay are common. One should be careful in pronouncing a fetus having ‘micrognathia’, especially on subjective evaluation, as this term implies that the fetus is abnormal with presence of significant pathology. There is no ‘gold standard’ for a definitive diagnosis of micrognathia on post-natal evaluation. Using a combination of objective sonographic markers as well as follow-up ultrasound assessments can significantly reduce the risk of a false diagnosis. Follow-up scans should be arranged, and neonatal service should be alerted in cases of ongoing pregnancies.

Item Type: Article
Additional Information: © The Author(s) 2019 Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.
Keywords: Fetal mandible, Micrognathia, Retrognathia, Inferior facial angle, Frontal nasomental angle, Jaw index, Mandibular gap, Chromosomal abnormalities, Genetic syndromes, Pierre Robin sequence
SGUL Research Institute / Research Centre: Academic Structure > Molecular and Clinical Sciences Research Institute (MCS)
Academic Structure > Molecular and Clinical Sciences Research Institute (MCS) > Vascular & Cardiac Surgery (INCCVC)
Journal or Publication Title: JOURNAL OF FETAL MEDICINE
ISSN: 2348-1153
Dates:
DateEvent
September 2019Published
25 July 2019Published Online
5 July 2019Accepted
Publisher License: Creative Commons: Attribution 4.0
Web of Science ID: WOS:000490037700001
URI: https://openaccess.sgul.ac.uk/id/eprint/111388
Publisher's version: https://doi.org/10.1007/s40556-019-00210-0

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