Purpose or Case Report: Midface anomalies in the fetus can present with a range of severity and corresponding neonatal morbidity, on a spectrum from cosmetic disturbance to airway obstruction. Immediate postpartum complications include life-threatening hypoxia and feeding disturbances. These anomalies not only present immediate difficulties but also often exist within a variety of syndromes with long-term consequences, affecting various organ systems. While screening ultrasound frequently can identify deviations from normal, fetal MRI may provide more detailed and high-resolution imaging for the characterization of midface anomalies and associated prenatal disease.
The identification of facial anomalies in utero should prompt further investigation for associated abnormalities, and will also allow for improved prenatal counseling, which can prepare parents for the immediate postpartum management including surgical planning and resource allocation. It furthermore provides a foundation to shape family expectations and to begin to frame psychosocial support, allowing parents to engage mentally and emotionally with the medical and surgical course that awaits.

In this presentation, we highlight the normal fetal midface as seen on MRI at various stages of development, and outline a systematic approach for evaluation of the fetal midface structures. Recognition of this typical appearance will allow the radiologist to identify the range of possible abnormalities that can occur and which can shape prognosis when properly identified. Various cases of midface anomalies will be reviewed and linked to their clinical significance, including cases with associated intracranial anomalies and deficiencies in swallowing and respiration.
Methods & Materials:
Results:
Conclusions: