Multidisciplinary team approach to the prenatal management of orofacial clefts: a single center cohort study in Taiwan

Advances in ultrasound fetal diagnostics and treatment have created a dilemma for doctors and parents: choosing whether to continue with a pregnancy as well as choosing between various treatment options. A multidisciplinary approach has been widely accepted in the management of other prenatally diag...

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Bibliographic Details
Published in:Scientific reports 2020-08, Vol.10 (1), p.13916-13916, Article 13916
Main Authors: Ko, Hsuan, Chang, Tung-Yao, Lussier, Eric C, Olisova, Ksenia, Sung, Chan-Yu, Chen, Philip Kuo-Ting, Li, Wen-Chu, Yang, Tze-Yi, Wang, Ru-Xuan
Format: Article
Language:English
Subjects:
Adult
Cleft Lip - diagnosis
Cleft Lip - therapy
Cleft Palate - diagnosis
Cleft Palate - therapy
Cohort analysis
Cohort Studies
Female
Fetuses
Humans
Maternal Age
Middle Aged
Orofacial clefts
Patient Care Team - trends
Pregnancy
Prenatal Care - methods
Prenatal Diagnosis - methods
Referral and Consultation
Retrospective Studies
Taiwan - epidemiology
Ultrasonography, Prenatal - methods
Ultrasound
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Summary:Advances in ultrasound fetal diagnostics and treatment have created a dilemma for doctors and parents: choosing whether to continue with a pregnancy as well as choosing between various treatment options. A multidisciplinary approach has been widely accepted in the management of other prenatally diagnosed anomalies and has shown superior results compared to routine care. We present a retrospective cohort of patients prenatally diagnosed with orofacial clefts who were offered consultation by an expert multidisciplinary team, including: a fetal medicine specialist, an obstetrician, a plastic surgeon, and a case managing nurse. We analyzed factors influencing parents' decision to utilize a consultation service, as well as their decision about pregnancy continuation. Our results suggest that the presence of other anomalies and maternal age heavily influenced the decision about the uptake of consultations. If consulted by the team, parents tended to continue with the pregnancy, even when accounting for fetal gender and maternal age. On the other hand, having a consultation had varying effects depending on the cleft type. The findings suggest that multidisciplinary consultations may be an efficient approach in managing pregnancies complicated by orofacial cleft anomalies; which may help in preventing unnecessary pregnancy terminations and developing a sufficient postnatal care plan.
ISSN:2045-2322
2045-2322
DOI:10.1038/s41598-020-70906-1