Prenatal diagnosis of binders phenotype: a cross road to decision making

Binder’s syndrome is an uncommon congenital condition which develops in the first trimester of pregnancy and has characteristic effects on the facial features. Those effects are: arhinoid face, intermaxillary hypoplasia (associated with malocclusion), abnormal position of the nasal bones, nasal mucosa atrophy, anterior nasal spine agenesis and (in most cases) a lack of frontal sinuses. Other deformities, as well as mental retardation, are also possible. Due to the rarity of the disease, there are no treatment trials for these patients. Treatments reported in the medical literature are part of single case reports or small case series of patients. Here is a case report of a 23-year-old who presented to OPD at 26 weeks with features of binders’ phenotype. This woman delivered an infant of 2.7 kg without other abnormalities and no respiratory distress postnatally. Sonographic evaluation during pregnancy depicts proper differential diagnosis and therapeutic strategy. Multidisciplinary approach is mandatory in order to establish meticulous treatment. Further studies must be conducted, achieving this ultimate scope. Even so, the parents should be counselled that Binder syndrome is a tentative diagnosis prenatally, and that not all genetic syndromes can be prenatally excluded.