• Marina Pekar-Zlotin, Natali Zilberman Sharon, Yaakov Melcer, Yael Tal-Bliman, Jodi Ezratty, Michal Feingold-Zadok, Ran Svirsky, and Ron Maymon.
• Department of Obstetrics and Gynecology, Shamir Medical Center (Assaf Harofeh), Zerifin, Israel, affiliated with Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
• Isr Med Assoc J. 2023 Oct 1; 25 (10): 678682678-682.

BackgroundFetal facial clefts are among the most common congenital anomalies detected prenatally. This finding may lead to termination of pregnancy in some cases.ObjectivesTo compare a cohort of fetuses with facial clefts in which the pregnancy was terminated to the cohort of cases that were born with facial clefts. To investigate risk factors for facial clefts.MethodsWe conducted a retrospective chart review of all women with prenatal and postnatal diagnosis of facial cleft that were managed in our institute. A telephone questionnaire was conducted regarding a positive family history and/or genetic predisposition for facial clefts abnormalities.ResultsThe final cohort consisted of two group. One group included 54 cases of termination of pregnancy (TOP) that were performed due to cleft lip (CL) or cleft palate (CLP); 27 women answered the telephone questionnaire. The second group comprised 99 women who delivered children with facial cleft during the same period; 60 answered the questionnaire. Only seven cases were diagnosed prenatal. Among the two groups, no correlation to family history was discovered. Of note, there was one case of three consecutive fetuses with CL in one woman, without any significant genetic findings.ConclusionsTo the best of our knowledge, this is the first study to describe an anatomical malformation posing an ethical dilemma before TOP. Primary prevention with folic acid and early sonographic detection of CL/CLP with multidisciplinary consultation should be considered.

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