**2. The fetal eyes**

**1.3. Coronal planes**

**1.4. Fetal face profile**

Evaluation of the integrity of the facial anatomy is assessed by visualizing the eyelids, orbits, lips, forehead, and nose, whose nostrils usually appear as two little anechoic areas. For these

**Figure 5.** A. Coronal anterior plane in a late first trimester (FT) fetus: The lens inside the corpus vitreum B. The tip of the nose, the alae nasi, and the columna are seen above the upper lip. The nostril typically appears as two little anechoic areas.

One of the most common "soft sonographic sings" providing essential clues of congenital syndromes [1] is the deviations from the proportions normally found during a sagittal fetal

features, coronal planes are more important than the previous one (**Figure 5**).

**Figure 4.** Axial scan of the lower fetal face demonstrating the upper lip and the anterior palate.

94 Congenital Anomalies - From the Embryo to the Neonate

From the late FT or in the early second trimester onward, we should consider the visualization of the fetal orbit and lens. The orbits will appear as echolucent circles on the upper fetal face, whereas the lens will be visualized inside these structures, as circular hyperechogenic rings. These images can be obtained during almost all scans, beginning with the late first trimester. Any deviation from the relative size might suggest congenital malformations of the orbits and lens. To assess them, coronal and especially axial planes of the fetal head are the best approach.
