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Prenatal ultrasound examination should take place between 18 and 20 week of gestation and is important for early detection of fetal anomalies such as the facial malformations. One important anatomic element is the palate that raises echographic technical difficulties such as the shadowing by facial bones and, especially, by the superior alveolar ridge, the fetal prone position and its localization, respectively, profoundly, inside of fetal head or anatomic obstacles such as the fetal tongue, so new echographic examination techniques are being under evaluation. The prenatal detection rate of fetal cleft palate remains low, so various methods of examination are being proposed. The ultrasound assessment of the fetal face is made by 2D ultrasound, technique completed by 3D ultrasound, which includes the evaluation in both axial and coronal planes, with the uvula being analyzed in two types of section, transversal and sagittal. In the latter to epiglottis is a landmark that confirms the identification of the uvula and a normal uvula has a typical and resembling echographic pattern to the equal sign. Even though prenatal diagnosis of soft palate cleft is a real challenge, with low detection rate due to difficulty of its visualization during routine examination, and even if suspected, diagnostic accuracy is low.

Gastroschisis is a congenital anterior abdominal wall defect that occurs in 4 to 5 in 10,000 births, consisting in the evisceration of bowel in the amniotic cavity without a membranous covering. Gastroschisis cases can be detected during the first trimester using ultrasonography or at the beginning of the second trimester with a detection rate of 100%. Although an isolated condition in most of the cases, further complications such as malrotation, atresia, stenosis, perforation or volvulus can be associated. Periodic monitoring is required to assess the progress of the pregnancy with measurements of the level of amniotic fluid, fetal biometry and bowel diameters at every ultrasound examination. Gastroschisis is most frequently associated with oligohydramnios, intrauterine fetal growth restriction, increased bowel wall thickness and bowel dilatation. The outcome of the disease is favourable with a survival rate of around 90% for born infants. The long time on ventilator and multiple intestinal surgeries that delay the moment of oral feeding with a long-term use of total parental nutrition and short bowel syndrome are the most important comorbidities. Delivery is recommended at 38 weeks of gestation, preserving caesarean delivery for complicated gastroschisis. Although a complex pathology, gastroschisis is associated with normal intellectual development and few to none long-term complications.

Goldenhar syndrome, also known as oculo-auriculo-vertebral syndrome, represents a rare congenital complex of anomalies, involving the development of the first and second brachial arches during the first embrionary stage. In addition to the craniofacial disorders, Goldenhar syndrome can include central nervous system, heart, skeleton or kidneys pathologies as well as vertebral defects. We present the case of a Goldenhar syndrome whose first pathologic sign was tetralogy of Fallot, with associated cardiovascular disorders (atrial septal defect type ostium secundum, and single umbilical artery) and bilateral microtia, with malformation of auditory canal, mandibular hypoplasia and a single epibulbar dermoid. The Goldenhar syndrome was diagnosed after birth, the article emphasizing the difficulties of prenatal diagnosis.