Recently, the news of “Faye Wong went to the United States for the plastic surgery of her “little Faye girl” born with harelip” has aroused widespread concern in the society. How far is congenital cleft lip and palate from us? Experts point out that the rising birth rate of deformed children in China is directly related to the lack of health awareness among parents. In order to popularize the knowledge of health care during pregnancy and to understand the causes and prevention of congenital cleft lip and palate children, we interviewed the relevant experts.
Reporter: What is the incidence of congenital cleft lip and palate in China? Is this disease frequently encountered?
Doctor: Congenital cleft lip and palate refers to cleft lip and palate, commonly known as “hare lip” and “wolf throat”. In recent years, the incidence has been on the rise in China, with epidemiological surveys showing an incidence of 1/700 or 1/1000 (depending on regional differences). In July 2006 alone, we treated 19 children and performed 7 more surgeries from August 1 to 14. Since schools are closed in July and August, parents mostly choose to have their children operated during this period.
Reporter: How much is the incidence of cleft lip and palate related to genetics?
Doctor: According to genetic studies, cleft lip is a polygenic hereditary disease. Of the more than 1,500 patients we have seen, about 3%; of them are congenitally inherited. However, the occurrence of cleft lip and palate deformities does not exclude other factors such as: endocrine disorders, viral infections, nutritional deficiencies, environmental pollution, mental factors, etc.
Congenital cleft lip and palate is generally more common in males than females. If the male partner has had a cleft lip and palate, he should go for an examination before marriage to consult if it is hereditary and how to prevent birth defects.
Reporter: Every patient with cleft lip and palate has a medical record, did you notice anything in the process of understanding the condition that pregnant women had before pregnancy or delivery that is worth reminding people about?
Doctor: Among the cleft lip and palate patients we see, 80% of the mothers complained that they had a cold one to two months before pregnancy or in the early stages of pregnancy. Colds may seem like a common illness, but viral colds should be taken seriously enough.
The types of malformations in infants depend on the type of teratogenic factors and their effects and the different periods of time. For example, rubella virus mainly causes cataracts, deafness, cleft lip and palate and heart malformations, while congenital cytomegalovirus mainly damages the central nervous system producing microcephaly or hydrocephalus. Since the embryo develops rapidly during the first trimester and is most sensitive to external teratogenic factors, pregnant women should put their health first during pregnancy.
Reporter: How does cleft lip and palate occur? What is the key to prevention?
Doctor: In terms of embryonic development, when the mother is 6 to 10 weeks pregnant, it is the time when the upper lip and palate are connected. Once disturbed by certain factors, it may affect the normal growth and development of the embryo’s jaw and face, and cleft lip and palate may occur.
To avoid the occurrence of cleft lip and palate, the key to prevention is in the first 12 weeks of pregnancy, when couples should be prepared to have children. They should smoke less and drink less alcohol in the first few months of pregnancy, and also avoid exposure to specific chemical drugs such as phenols, pesticides, antihistamines or anticonvulsant drugs, radiation, etc. Avoid viral infections caused by colds and herpes viruses in the early stages of pregnancy.
Reporter: Why is the key to prevention in the first 12 weeks of pregnancy?
Doctor: When the mother is pregnant, a new life begins to grow and develop, that is to say, after the fertilized egg is laid until about 12 weeks, it is the stage when the embryo and fetal organs are in high differentiation and rapid development. Generally speaking, brain development is 20-40 days after fertilization, eye development is 24-39 days after fertilization, limb development is 24-46 days after fertilization, and external genitalia development is 36-98 days after fertilization, etc. After the 9th week of fertilization, the embryo completes the differentiation of organs other than the nervous system and reproductive organs into the fetal stage, at which time the sensitivity to external teratogenic factors is relatively reduced. From the 13th week of pregnancy onward, the influence of external teratogenic factors is somewhat less.
Reporter: What are the disorders that can occur in children with cleft lip and palate? Is surgery the only treatment for congenital cleft lip and palate? When is the best time for surgical treatment?
Doctors: Children with cleft lip and palate will have facial, psychological, speech, hearing, physical, physical ability, interest and ability disorders.
Surgical correction is the only way to restore normal facial form and function in patients with congenital cleft lip and palate. There are three types of congenital cleft lip and palate: unilateral cleft lip, bilateral cleft lip, and mixed, and among the three, they are divided into mild, moderate, and severe. It is generally considered best to operate at 3 months for unilateral cleft lip and 6 months for bilateral cleft lip. If there is a cleft palate, surgery can be performed at around 10 months of age. Whether the child is suitable for surgery depends on the physical condition, but any surgery is related to the doctor’s level and anesthesia technique.
Reporter: How old can the youngest patient be operated on? Is the earlier the treatment, the better?
Doctor: In principle, the earlier the treatment, the better, but it also depends on the specific situation. The youngest surgery in our hospital is on the third day of life. With timely treatment, babies with cleft lip and palate deformities can recover as normal, both in appearance and in terms of development and speech function.
Once the baby is conceived in October, it is delivered. We wish Faye Wong and her “little Faye” a happy and healthy life, and we wish every new mother to be free from deformities.