It is with great pleasure that I hold in my hands this impressive book of Dr. Lakshmy and Dr. Thasleem on First and Midtrimester Ultrasound Diagnosis of Orofacial Clefts: An Atlas and Guide. Facial clefts are among the most common structural anomalies in humans, with an incidence of 1:600 live births and necessitating medical intervention in the neonatal period and beyond. Prenatal diagnosis of facial clefts is crucial in order to plan delivery at a specialised centre and to prepare the parents for the postnatal procedures. Facial clefts are also markers of numerous syndromic conditions and their detection should alert the examiner to look for additional anomalies in the fetus. For this reason, it is important to have the diagnosis achieved as early as possible in pregnancy, such as in the rst trimester of gestation. Detection rate of facial clefts in the rst trimester is still low as shown in large cohort studies, and this book will undoubtedly play a major role in expanding knowl­edge, which will translate into improved prenatal detection and outcome. The authors of this book have presented in the last few years several scientic papers, showing how to improve diagnosis in early gestation by using various planes and signs including the retronasal triangle, the maxillary gap and the newly reported superimposed lines sign. Their strong commitment to improve antenatal detection of facial clefts, culminated with the publication of this dedicated book.

The book is very well structured and is presented in 13 chapters with the most up-to-date knowledge on this eld. The systematic approach includes chapters on epidemiology and genetics, embryology of the fetal face, the pri­mary, secondary palate and the vomer, followed by the classication of oro­facial clefts. Ultrasound anatomy of the palate at 11 to 14 weeks and at 20 weeks of gestation is very well presented with exceptional drawings and g­ures and complemented by the presentation of the ultrasound signs and mark­ers, which can be applied in the detection of palatine clefts. The use of 3D techniques in the rst and second trimester is also well described. Protocols for the detection of facial clefts are also presented. A chapter on associated syndromic conditions and future aspects complete this guide and atlas. The book includes a total of more than 170 high-resolution gures and schemes in addition to a link to 35 videos fullling nicely the title of this book as being not only a guide but also an atlas. We have debated for years the role of the rst trimester ultrasound as whether it is just a screening for aneuploidy or an early anatomy survey. This debate is no longer valid, as this book of Drs. Lakshmy and Thasleem completes the detailed rst trimester anatomy scan

This book is organised into thirteen chapters. The rst chapter highlights the burden of orofacial clefts and the need for prenatal diagnosis. This is fol­lowed by the second chapter which deals with embryology and anatomy of the palate. A simple brief description of the classication of orofacial cleft is dealt with. Subsequently, the chapters are equally divided between rst tri­mester and mid-trimester diagnosis. The sonoanatomy, diagnosis and deni­tion of the type and extent of cleft along with multiplanar imaging have been dealt in an easily understandable format.

The readers are encouraged to refer to more literature regarding counsel­ling and prognostic implications for the management of orofacial clefts. This

book possible.