Prenatal Binder Phenotype: Physician’s Dilemma-A Case Report

The Binder phenotype is defined by midface hypoplasia, underdeveloped frontal sinuses, hypoplastic and abnormally positioned nasal bones, nostrils appearing moon or comma-shaped and prognathism. It is heterogeneous in etiology and not fully understood. Multiple causative factors are described. The physician’s dilemma is of diagnosing the fetal abnormalities on antenatal ultrasound for which there is no confirmatory testing. There are management and ethical problems regarding the diagnosis, further investigations and confirmation of the diagnosis. The Binder phenotype is a clinical diagnosis with multiple differential diagnoses. It carries an uncertain and unpredictable course and prognosis which might be difficult for both clinician and parents to predict and comprehend. Genetic counseling has to be variable depending upon the diagnosis.