Solution: Cleft lip is one of the most common of congenital deformities, occurring in 1 in a 1,000 live births. It is due to insufficient mesenchymal migration during palate formation in the fourth through seventh week of life. It is sometimes associated with anomalies involving multiple organs. Left sided clefts are most frequent, followed by right and then bilateral, which is relatively rare. There is generally (50% of the time) as associated cleft palate. I did not provide enough images to make that determination in this case. Surgical repair is generally performed 2-3 months after birth. Findings on OB US are identified here with the nose/lips shot showing a defect in the upper lip. Note that this abnormality often will not be appreciated on the profile image.