Abstract
The purpose of this research was to analyze the problems of the diagnosis of the cleft lip and palate (CLP) using the ultrasound before delivery and information CLP of the babies to their parents and to discuss the network betweent he obstetriciana nd the rehabilitationte am and the system of support the babies with CLP as well as their parents. We sent questionaires to obstetricians in Fukuoka, Yamaguchi, Ooita, Saga prefectures concerning the diagnosis of CLP using the ultrasound and analyze our cases from the Handicap Center in Kitakyushu City. We obtained the following results.
1. We gave the questionairet o 530 obstetriciansa, nd 257 filled the questionaire. The ratio of return was 52%.
2.215 obstetricians (83.7%) encountered delivery of babies with CLP.
3.82 of all of the obstetrician (38.1%) were familiar with the Hotz plate and 17 had used the Hotz plate before. The obstetricians had discovered and diagnosed CLP of the fetus using the ultrasound in the 18 th week of gestation at the earliest and most cases were diagnosed about from the 30 th to the 32 th week of gestation.
4. After the diagnosis,40 obstetricians (32.5%) informed the parents at pre delivery about CLP and 68 (55.3%) informed after delivery and 15 (12.2%) were case by case.40 obstetricians who informed CLP before delivery,28 (70%) informed just at the time CLP was diagnosed and 6 (15%)informed at just delivery.
5. Factors that influenced the decision whether the obstetrician informed before delivery or not were the charactero f the mother 133 (27.8%) and the broadmindednesos f the father 123 (25.7%), as well as the cooperation of the parents 109 (22.8%).
6. There were no relationshipsb etweent he negative reactiona t the time when parents were informed of CLP and the type of CLP, composition of the family members and the presence any other child 1098 with congenital anomalies.
7. Of the cases that have gone to the Handicap Center in Kitakyushu City,12 cases were diagnosed and informed of CLP before delivery, and in about 9 cases we obtained the answeres to the questions.12 parent answered when informed of CLP of their baby, that if there were any explanations of the supporting system after delivery, the information was better before delivery.4 answered it was best before delivery under any condition. In particular,3 of 7 mothers chosed information before delivery regardless of any condition.
