3- D and 4-D (live 3-D) Fetal Sonography

3- D and 4-D (live 3-D) Fetal Sonography
Our office is fully equipped with three ultrasound machines, all of which are capable of 3-D and live 3-D imaging. It is important to understand that 2-D imaging is the standard evaluation of all pregnancies. It is imperative that a high-level detailed 2-D ultrasound is performed to evaluate the pregnancy for fetal, placental, cord, uterine, cervical, or ovarian abnormalities. Currently, medical literature supports only a small role for 3-D and live 3-D imaging in the evaluation of the fetus, though this is increasing in size especially in the areas of fetal face, heart, and behavior evaluations. If a sonographer is not skilled in 2-D imaging, they cannot perform 3-D or live 3-D imaging, except for entertainment purposes which is not medically advisable.

In our office we use 3-D and live 3-D imaging for medical purposes in a variety of circumstances. One is in the presence of a fetal abnormality detected on 2-D imaging where we determine the need to store the ultrasound data in volume format so that further assessment of the abnormality can be done after the patient leaves the office allowing more accurate diagnoses of certain abnormalities such as spina bifida. Another is when we perform fetal cardiac echography and the 3-D volume allows for more detailed evaluation of the fetal heart anatomy than 2-D imaging. Yet another is when we assess fetal face for abnormalities such as skin tags or when we assess the fetal secondary palate (the roof of the mouth) which can not be assessed by 2-D imaging.

For adequate 3-D imaging there are fetal and maternal requirements that if not met will not produce the expected results. For example, 3-D imaging of the fetal face requires perfect fetal position, unobstructed by fetal hands, feet, umbilical cord, presence of adequate amniotic fluid around the face, not so active a fetus at the time of the imaging, and a pregnant women who is not too overweight. Only seventy five percent of fetuses allow for a good 3-D and live 3-D imaging.