To investigate the value of sagittal plane ultrasound image in the screening of fetal cleft palate in the first trimester.

The sagittal plane ultrasound images of 31 cases of fetal cleft palate in the first trimester at Guangdong Women and Children Hospital from January 2018 to December 2019 were studied retrospectively to analyze the abnormal signs and summarize the ultrasonic manifestations of different types of cleft palate in the sagittal plane and other structural exceptions.

Ultrasonograms showed that 28 (90.3%, 28/31) cases had maxillary gap, including 14 cases of unilateral cleft palate, 5 cases of bilateral cleft palate, and 9 cases of median cleft palate; 27 (87.1%, 27/31) had no 'superimposed line sign', including 5 cases of median cleft palate, 15 cases of unilateral cleft palate, 6 cases of bilateral cleft palate, and 1 case of simple cleft palate; and 6 (19.4%, 6/31) had premaxillary protrusion that all occurred in bilateral cleft lip and palate. In the cases diagnosed in the first and second trimester of pregnancy, the incidence of fetal structural abnormalities was 75.0% (15/20) and 45.5% (5/11), respectively, and nuchal translucency thickening was found in 60.0% (12/20) and 36.4% (4/11) of cases, respectively.

Maxillary gap and disappearance of 'superimposed line' sign in the sagittal plane are important clues for screening fetal cleft palate in the first trimester of pregnancy, and premaxillary protrusion is a characteristic ultrasonographic manifestation of bilateral cleft palate.