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Secondary bone grafting for alveolar cleft in children with cleft lip or cleft lip and palate

Alveolar cleft is a bony defect in the gum of the mouth, which affects approximately 75% of cleft lip or cleft lip and palate patients. Failure to repair this defect may give rise to many problems. Although alveolar bone grafting has been widely accepted by professionals within cleft care, there is still controversy around the technique, timing, site from which bone is taken and whether artificial bone substitutes offer any benefits. One question is whether the type of graft material using artificial bone materials alone might have similar success to the traditional bone harvested from the hip when assessed clinically, by radiographic images and in reducing problems in the operated area.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2011

Feeding interventions for growth and development in infants with cleft lip, cleft palate or cleft lip and palate

Cleft lip and cleft palate (the roof of the mouth) are common defects. The severity of the cleft (opening) varies and it can occur on one (unilateral) or both sides (bilateral). It can be difficult to feed babies enough nutritious food when they have this condition, and there is evidence of delayed development in children born with cleft.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2011

Electropalatography for articulation disorders associated with cleft palate

A cleft palate means that during the early stages of pregnancy, the baby’s roof of the mouth does not join in the normal way. The lip is sometimes cleft as well as the palate. Children who are born with a cleft lip or palate usually have corrective surgery during the first few years of life. Nowadays, surgery is so good that there are few long term consequences.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2009

Folic acid supplements before conception and in early pregnancy (up to 12 weeks) for the prevention of birth defects

Folic acid is a synthetic form of folate used in supplements and fortified foods (like wheat and maize flour) to reduce the occurrence of neural tube defects (NTDs). These include spina bifida (or cleft spine), where there is an opening in one or more of the bones (vertebrae) of the spinal column, and anencephaly where the head (cephalic) end of the neural tube fails to close. Supplementation with folic acid is internationally recommended to women from the moment they are trying to conceive until 12 weeks of pregnancy. Another option recommended by the World Health Organization (WHO) is that women of reproductive age take weekly iron and folic acid supplements, especially in populations where the prevalence of anaemia is above 20%. Supplementation may also reduce other birth defects such as cleft lip with or without cleft palate and congenital cardiovascular defects. Recently, 5‐methyl‐tetrahydrofolate (5‐MTHF) has been proposed as an alternative to folic acid supplementation. This is because most dietary folate and folic acid are metabolised to 5‐MTHF. Some women have gene characteristics which reduce folate concentration in blood.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2010

Trials of interventions for pregnant women who are obese to lose weight and improve pregnancy outcomes.

Pregnant women who are obese risk serious complications for themselves and their children. The mother is more likely to develop diabetes or high blood pressure or pre‐eclampsia during pregnancy, and the pregnancy may end in a miscarriage or stillbirth. The baby could have serious anomalies at birth, including spina bifida, cardiovascular anomalies, cleft lip and palate, or limb reduction anomalies. Some obese women have premature births. At birth, the labour may be longer and other complications can lead to a caesarean birth. The baby may also be bigger at birth than is normal, and there is evidence that the children of obese mothers go on to be obese. The advice for obese women in managing their weight during pregnancy is that weight loss should be avoided, and weight gain should be between 5.0 and 9.1 kg. Yet observational studies of large numbers of pregnant women indicate that some obese women, especially those who are heavier, lose weight during pregnancy. We do not have any clear results that indicate that losing weight when pregnant is safe for a mother who is obese, or for her baby. This Cochrane review aimed to evaluate trials that were designed for obese pregnant women to lose weight. No randomised controlled trials were found. We recommend that further research is conducted to evaluate the safety of interventions for weight loss when a woman is pregnant and obese for the mother and her baby.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2013

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