Bilateral cleft lip and palate associated with increased nuchal translucency and maternal cocaine abuse at 14 weeks of gestation

A case of bilateral cleft lip and palate associated with increased fetal nuchal translucency detected at 14 weeks of gestation in a cocaine abusing pregnant woman is presented. There were no other associated structural or chromosomal abnormalities. We propose that systematic examination in both the sagittal and parasagittal plane of the fetal profile and recognition of the characteristic ultrasound appearance of a premaxillary protruding echogenic mass should make detection of this type of cleft relatively easy at the moment of the first trimester scan. First trimester diagnosis of cleft lip and palate can facilitate the parental decision-making process on continuing or terminating the pregnancy and should open the perspective of fetal surgery.