Which prenatal screening could have detected a cleft lip at 13 to 14 weeks gestation?

• A. Amniotic fluid analysis.
• B. Ultrasound screening.
• C. Maternal serum alpha-fetoprotein.
• D. Noninvasive prenatal testing.

Answer: (B)

Ultrasound screening is able to visualize the fetus’s facial structures, so it can detect a cleft lip during the 13 to 14 weeks window when a detailed anomaly scan or enhanced facial imaging is performed. With high-quality 2D imaging or 3D/4D ultrasound and a skilled operator, the gap in the lip can be seen as the lip and palate form, allowing early identification and planning.

Other options don’t directly image anatomy. Amniotic fluid analysis involves sampling fetal cells to assess genetics, not facial structure. Maternal serum alpha-fetoprotein is a biochemical screen for neural tube and ventral wall defects and is not specific for facial clefts. Noninvasive prenatal testing analyzes fetal DNA for chromosomal abnormalities and likewise does not assess facial anatomy.