Skip to main content
SpringerLink
Log in

Three-Dimensional Ultrasound: A Role in Early Pregnancy?

  • Chapter
Book cover First-Trimester Ultrasound

  • 2169 Accesses

Abstract

Three-dimensional ultrasound (3DUS) allows imaging of anatomical structures in multiple planes, some of which are not possible with conventional two-dimensional ultrasound (2DUS). This provides an advantage when imaging early embryonic or fetal structures by transvaginal ultrasonography, since manipulation of the transvaginal probe is more restricted in space when compared to the transabdominal probe. Several case reports and series highlight potential benefits of 3DUS to study the early embryonic anatomy in vivo (sonoembryology) as well as for the early diagnosis of congenital anomalies. However, comparative studies between 2DUS and 3DUS for early first trimester diagnosis are lacking. In this chapter we review the potential role of 3DUS for early diagnosis of congenital anomalies, including congenital heart disease.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 89.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 119.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Rottem S, Bronshtein M, Thaler I, Brandes JM. First trimester transvaginal sonographic diagnosis of fetal anomalies. Lancet. 1989;1:444–5.

    Article  CAS  PubMed  Google Scholar 

  2. Rottem S, Bronshtein M. Transvaginal sonographic diagnosis of congenital anomalies between 9 weeks and 16 weeks, menstrual age. J Clin Ultrasound. 1990;18:307–14.

    Article  CAS  PubMed  Google Scholar 

  3. Achiron R, Tadmor O. Screening for fetal anomalies during the first trimester of pregnancy: transvaginal versus transabdominal sonography. Ultrasound Obstet Gynecol. 1991;1:186–91.

    Article  CAS  PubMed  Google Scholar 

  4. Timor-Tritsch IE, Monteagudo A, Peisner DB. High-frequency transvaginal sonographic examination for the potential malformation assessment of the 9-week to 14-week fetus. J Clin Ultrasound. 1992;20:231–8.

    Article  CAS  PubMed  Google Scholar 

  5. Achiron R, Weissman A, Rotstein Z, Lipitz S, Mashiach S, Hegesh J. Transvaginal echocardiographic examination of the fetal heart between 13 and 15 weeks’ gestation in a low-risk population. J Ultrasound Med. 1994;13:783–9.

    CAS  PubMed  Google Scholar 

  6. Souka AP, Pilalis A, Kavalakis Y, Kosmas Y, Antsaklis P, Antsaklis A. Assessment of fetal anatomy at the 11-14-week ultrasound examination. Ultrasound Obstet Gynecol. 2004;24:730–4.

    Article  CAS  PubMed  Google Scholar 

  7. Ebrashy A, El Kateb A, Momtaz M, et al. 13-14-week fetal anatomy scan: a 5-year prospective study. Ultrasound Obstet Gynecol. 2010;35:292–6.

    Article  CAS  PubMed  Google Scholar 

  8. Katorza E, Achiron R. Early pregnancy scanning for fetal anomalies – the new standard? Clin Obstet Gynecol. 2012;55:199–216.

    Article  PubMed  Google Scholar 

  9. Salomon LJ, Alfirevic Z, Bilardo CM, et al. ISUOG practice guidelines: performance of first-trimester fetal ultrasound scan. Ultrasound Obstet Gynecol. 2013;41:102–13.

    Article  CAS  PubMed  Google Scholar 

  10. Guariglia L, Rosati P. Transvaginal sonographic detection of embryonic-fetal abnormalities in early pregnancy. Obstet Gynecol. 2000;96:328–32.

    Article  CAS  PubMed  Google Scholar 

  11. Iliescu D, Tudorache S, Comanescu A, et al. Improved detection rate of structural abnormalities in the first trimester using an extended examination protocol. Ultrasound Obstet Gynecol. 2013;42:300–9.

    Article  CAS  PubMed  Google Scholar 

  12. Bromley B, Shipp TD, Lyons J, Navathe RS, Groszmann Y, Benacerraf BR. Detection of fetal structural anomalies in a basic first-trimester screening program for aneuploidy. J Ultrasound Med. 2014;33:1737–45.

    Article  PubMed  Google Scholar 

  13. Bronshtein M, Solt I, Blumenfeld Z. The advantages of early midtrimester targeted fetal systematic organ screening for the detection of fetal anomalies–will a global change start in Israel? Harefuah. 2014;153:320–4.

    PubMed  Google Scholar 

  14. Becker R, Wegner RD. Detailed screening for fetal anomalies and cardiac defects at the 11-13-week scan. Ultrasound Obstet Gynecol. 2006;27:613–8.

    Article  CAS  PubMed  Google Scholar 

  15. Lombardi CM, Bellotti M, Fesslova V, Cappellini A. Fetal echocardiography at the time of the nuchal translucency scan. Ultrasound Obstet Gynecol. 2007;29:249–57.

    Article  CAS  PubMed  Google Scholar 

  16. Persico N, Moratalla J, Lombardi CM, Zidere V, Allan L, Nicolaides KH. Fetal echocardiography at 11-13 weeks by transabdominal high-frequency ultrasound. Ultrasound Obstet Gynecol. 2011;37:296–301.

    Article  CAS  PubMed  Google Scholar 

  17. Vinals F, Ascenzo R, Naveas R, Huggon I, Giuliano A. Fetal echocardiography at 11 + 0 to 13 + 6 weeks using four-dimensional spatiotemporal image correlation telemedicine via an Internet link: a pilot study. Ultrasound Obstet Gynecol. 2008;31:633–8.

    Article  CAS  PubMed  Google Scholar 

  18. Bennasar M, Martinez JM, Olivella A, et al. Feasibility and accuracy of fetal echocardiography using four-dimensional spatiotemporal image correlation technology before 16 weeks’ gestation. Ultrasound Obstet Gynecol. 2009;33:645–51.

    Article  CAS  PubMed  Google Scholar 

  19. Votino C, Cos T, Abu-Rustum R, et al. Use of spatiotemporal image correlation at 11-14 weeks’ gestation. Ultrasound Obstet Gynecol. 2013;42:669–78.

    Article  CAS  PubMed  Google Scholar 

  20. Espinoza J, Lee W, Vinals F, et al. Collaborative study of 4-dimensional fetal echocardiography in the first trimester of pregnancy. J Ultrasound Med. 2014;33:1079–84.

    Article  PubMed  Google Scholar 

  21. Goldstein I, Weizman B, Nizar K, Weiner Z. The nuchal translucency examination leading to early diagnosis of structural fetal anomalies. Early Hum Dev. 2014;90:87–91.

    Article  PubMed  Google Scholar 

  22. Haak MC, van Vugt JM. Echocardiography in early pregnancy: review of literature. J Ultrasound Med. 2003;22:271–80.

    PubMed  Google Scholar 

  23. Bronshtein M, Zimmer EZ. The sonographic approach to the detection of fetal cardiac anomalies in early pregnancy. Ultrasound Obstet Gynecol. 2002;19:360–5.

    Article  CAS  PubMed  Google Scholar 

  24. Achiron R, Rotstein Z, Lipitz S, Mashiach S, Hegesh J. First-trimester diagnosis of fetal congenital heart disease by transvaginal ultrasonography. Obstet Gynecol. 1994;84:69–72.

    CAS  PubMed  Google Scholar 

  25. Yagel S, Weissman A, Rotstein Z, et al. Congenital heart defects: natural course and in utero development. Circulation. 1997;96:550–5.

    Article  CAS  PubMed  Google Scholar 

  26. Benacerraf BR, Lister JE, DuPonte BL. First-trimester diagnosis of fetal abnormalities. A report of three cases. J Reprod Med. 1988;33:777–80.

    CAS  PubMed  Google Scholar 

  27. Cullen MT, Green J, Whetham J, Salafia C, Gabrielli S, Hobbins JC. Transvaginal ultrasonographic detection of congenital anomalies in the first trimester. Am J Obstet Gynecol. 1990;163:466–76.

    Article  CAS  PubMed  Google Scholar 

  28. Syngelaki A, Chelemen T, Dagklis T, Allan L, Nicolaides KH. Challenges in the diagnosis of fetal non-chromosomal abnormalities at 11-13 weeks. Prenat Diagn. 2011;31:90–102.

    Article  PubMed  Google Scholar 

  29. Yagel S, Achiron R, Ron M, Revel A, Anteby E. Transvaginal ultrasonography at early pregnancy cannot be used alone for targeted organ ultrasonographic examination in a high-risk population. Am J Obstet Gynecol. 1995;172:971–5.

    Article  CAS  PubMed  Google Scholar 

  30. Hernadi L, Torocsik M. Screening for fetal anomalies in the 12th week of pregnancy by transvaginal sonography in an unselected population. Prenat Diagn. 1997;17:753–9.

    Article  CAS  PubMed  Google Scholar 

  31. D’Ottavio G, Mandruzzato G, Meir YJ, et al. Comparisons of first and second trimester screening for fetal anomalies. Ann N Y Acad Sci. 1998;847:200–9.

    Article  PubMed  Google Scholar 

  32. Comas Gabriel C, Galindo A, Martinez JM, et al. Early prenatal diagnosis of major cardiac anomalies in a high-risk population. Prenat Diagn. 2002;22:586–93.

    Article  CAS  PubMed  Google Scholar 

  33. Timor-Tritsch IE, Peisner DB, Raju S. Sonoembryology: an organ-oriented approach using a high-frequency vaginal probe. J Clin Ultrasound. 1990;18:286–98.

    Article  CAS  PubMed  Google Scholar 

  34. Benoit B, Hafner T, Kurjak A, Kupesic S, Bekavac I, Bozek T. Three-dimensional sonoembryology. J Perinat Med. 2002;30:63–73.

    PubMed  Google Scholar 

  35. Timor-Tritsch IE, Farine D, Rosen MG. A close look at early embryonic development with the high-frequency transvaginal transducer. Am J Obstet Gynecol. 1988;159:676–81.

    Article  CAS  PubMed  Google Scholar 

  36. Takeuchi H. Transvaginal ultrasound in the first trimester of pregnancy. Early Hum Dev. 1992;29:381–4.

    Article  CAS  PubMed  Google Scholar 

  37. Blaas HG, Eik-Nes SH, Kiserud T, Berg S, Angelsen B, Olstad B. Three-dimensional imaging of the brain cavities in human embryos. Ultrasound Obstet Gynecol. 1995;5:228–32.

    Article  CAS  PubMed  Google Scholar 

  38. Blaas HG, Eik-Nes SH, Berg S, Torp H. In-vivo three-dimensional ultrasound reconstructions of embryos and early fetuses. Lancet. 1998;352:1182–6.

    Article  CAS  PubMed  Google Scholar 

  39. Blaas HG, Taipale P, Torp H, Eik-Nes SH. Three-dimensional ultrasound volume calculations of human embryos and young fetuses: a study on the volumetry of compound structures and its reproducibility. Ultrasound Obstet Gynecol. 2006;27:640–6.

    Article  PubMed  Google Scholar 

  40. Pooh RK, Pooh KH. The assessment of fetal brain morphology and circulation by transvaginal 3D sonography and power Doppler. J Perinat Med. 2002;30:48–56.

    PubMed  Google Scholar 

  41. Zanforlin Filho SM, Araujo Junior E, Guiaraes Filho HA, Pires CR, Nardozza LM, Moron AF. Sonoembryology by three-dimensional ultrasonography: pictorial essay. Arch Gynecol Obstet. 2007;276:197–200.

    Article  PubMed  Google Scholar 

  42. Kim MS, Jeanty P, Turner C, Benoit B. Three-dimensional sonographic evaluations of embryonic brain development. J Ultrasound Med. 2008;27:119–24.

    PubMed  Google Scholar 

  43. Atanasova D, Markov D, Pavlova E, Markov P, Ivanov S. Three-dimensional sonoembryology–myth or reality. Akush Ginekol. 2010;49:26–30.

    CAS  Google Scholar 

  44. Pooh RK, Shiota K, Kurjak A. Imaging of the human embryo with magnetic resonance imaging microscopy and high-resolution transvaginal 3-dimensional sonography: human embryology in the 21st century. Am J Obstet Gynecol. 2011;204:77.e1–16.

    Article  Google Scholar 

  45. Pooh RK. Neurosonoembryology by three-dimensional ultrasound. Semin Fetal Neonatal Med. 2012;17:261–8.

    Article  PubMed  Google Scholar 

  46. Pooh RK, Kurjak A. Novel application of three-dimensional HDlive imaging in prenatal diagnosis from the first trimester. J Perinat Med. 2015;43:147.

    PubMed  Google Scholar 

  47. Bonilla-Musoles F, Raga F, Osborne NG, Blanes J. Use of three-dimensional ultrasonography for the study of normal and pathologic morphology of the human embryo and fetus: preliminary report. J Ultrasound Med. 1995;14:757–65.

    CAS  PubMed  Google Scholar 

  48. Blaas HG, Eik-Nes SH. First-trimester diagnosis of fetal malformations. In: Rodeck C, Whittle M, editors. Fetal medicine: basic science and clinical practice. London: Harcourt Brace; 1999. p. 581–97.

    Google Scholar 

  49. Blaas HG, Eik-Nes SH, Isaksen CV. The detection of spina bifida before 10 gestational weeks using two- and three-dimensional ultrasound. Ultrasound Obstet Gynecol. 2000;16:25–9.

    Article  CAS  PubMed  Google Scholar 

  50. Blaas HG, Eik-Nes SH, Vainio T, Isaksen CV. Alobar holoprosencephaly at 9 weeks gestational age visualized by two- and three-dimensional ultrasound. Ultrasound Obstet Gynecol. 2000;15:62–5.

    Article  CAS  PubMed  Google Scholar 

  51. Tonni G, Ventura A, Centini G, De Felice C. First trimester three-dimensional transvaginal imaging of alobar holoprosencephaly associated with proboscis and hypotelorism (ethmocephaly) in a 46,XX fetus. Congenit Anom (Kyoto). 2008;48:51–5.

    Article  Google Scholar 

  52. Timor-Tritsch IE, Monteagudo A, Santos R. Three-dimensional inversion rendering in the first- and early second-trimester fetal brain: its use in holoprosencephaly. Ultrasound Obstet Gynecol. 2008;32:744–50.

    Article  CAS  PubMed  Google Scholar 

  53. Blaas HG, Eik-Nes SH. Sonoembryology and early prenatal diagnosis of neural anomalies. Prenat Diagn. 2009;29:312–25.

    Article  PubMed  Google Scholar 

  54. Dane B, Dane C, Aksoy F, Yayla M. Semilobar holoprosencephaly with associated cyclopia and radial aplasia: first trimester diagnosis by means of integrating 2D-3D ultrasound. Arch Gynecol Obstet. 2009;280:647–51.

    Article  PubMed  Google Scholar 

  55. Bromley B, Shipp TD, Benacerraf BR. Structural anomalies in early embryonic death: a 3-dimensional pictorial essay. J Ultrasound Med. 2010;29:445–53.

    PubMed  Google Scholar 

  56. Blaas HG, Eik-Nes SH, Kiserud T, Hellevik LR. Early development of the hindbrain: a longitudinal ultrasound study from 7 to 12 weeks of gestation. Ultrasound Obstet Gynecol. 1995;5:151–60.

    Article  CAS  PubMed  Google Scholar 

  57. Maymon R, Halperin R, Weinraub Z, Herman A, Schneider D. Three-dimensional transvaginal sonography of conjoined twins at 10 weeks: a case report. Ultrasound Obstet Gynecol. 1998;11:292–4.

    Article  CAS  PubMed  Google Scholar 

  58. Kurjak A, Pooh RK, Merce LT, Carrera JM, Salihagic-Kadic A, Andonotopo W. Structural and functional early human development assessed by three-dimensional and four-dimensional sonography. Fertil Steril. 2005;84:1285–99.

    Article  PubMed  Google Scholar 

  59. Forest CP, Goodman D, Hahn RG. Meningomyelocele: early detection using 3-dimensional ultrasound imaging in the family medicine center. J Am Board Fam Med. 2010;23:270–2.

    Article  PubMed  Google Scholar 

  60. Blaas HG. Detection of structural abnormalities in the first trimester using ultrasound. Best Pract Res Clin Obstet Gynaecol. 2014;28:341–53.

    Article  PubMed  Google Scholar 

  61. Sleurs E, Goncalves LF, Johnson A, et al. First-trimester three-dimensional ultrasonographic findings in a fetus with frontonasal malformation. J Matern Fetal Neonatal Med. 2004;16:187–97.

    Article  CAS  PubMed  Google Scholar 

  62. Gindes L, Matsui H, Achiron R, Mohun T, Ho SY, Gardiner H. Comparison of ex-vivo high-resolution episcopic microscopy with in-vivo four-dimensional high-resolution transvaginal sonography of the first-trimester fetal heart. Ultrasound Obstet Gynecol. 2012;39:196–202.

    Article  CAS  PubMed  Google Scholar 

  63. Economides DL, Braithwaite JM. First trimester ultrasonographic diagnosis of fetal structural abnormalities in a low risk population. Br J Obstet Gynaecol. 1998;105:53–7.

    Article  CAS  PubMed  Google Scholar 

  64. Whitlow BJ, Chatzipapas IK, Lazanakis ML, Kadir RA, Economides DL. The value of sonography in early pregnancy for the detection of fetal abnormalities in an unselected population. Br J Obstet Gynaecol. 1999;106:929–36.

    Article  CAS  PubMed  Google Scholar 

  65. Carvalho MH, Brizot ML, Lopes LM, Chiba CH, Miyadahira S, Zugaib M. Detection of fetal structural abnormalities at the 11-14 week ultrasound scan. Prenat Diagn. 2002;22:1–4.

    Article  CAS  PubMed  Google Scholar 

  66. den Hollander NS, Wessels MW, Niermeijer MF, Los FJ, Wladimiroff JW. Early fetal anomaly scanning in a population at increased risk of abnormalities. Ultrasound Obstet Gynecol. 2002;19:570–4.

    Article  Google Scholar 

  67. Drysdale K, Ridley D, Walker K, Higgins B, Dean T. First-trimester pregnancy scanning as a screening tool for high-risk and abnormal pregnancies in a district general hospital setting. J Obstet Gynaecol. 2002;22:159–65.

    Article  PubMed  Google Scholar 

  68. Taipale P, Ammala M, Salonen R, Hiilesmaa V. Two-stage ultrasonography in screening for fetal anomalies at 13-14 and 18-22 weeks of gestation. Acta Obstet Gynecol Scand. 2004;83:1141–6.

    Article  PubMed  Google Scholar 

  69. Chen M, Lam YH, Lee CP, Tang MH. Ultrasound screening of fetal structural abnormalities at 12 to 14 weeks in Hong Kong. Prenat Diagn. 2004;24:92–7.

    Article  PubMed  Google Scholar 

  70. Saltvedt S, Almstrom H, Kublickas M, Valentin L, Grunewald C. Detection of malformations in chromosomally normal fetuses by routine ultrasound at 12 or 18 weeks of gestation-a randomised controlled trial in 39,572 pregnancies. BJOG. 2006;113:664–74.

    Article  CAS  PubMed  Google Scholar 

  71. Cedergren M, Selbing A. Detection of fetal structural abnormalities by an 11-14-week ultrasound dating scan in an unselected Swedish population. Acta Obstet Gynecol Scand. 2006;85:912–5.

    Article  PubMed  Google Scholar 

  72. Dane B, Dane C, Sivri D, Kiray M, Cetin A, Yayla M. Ultrasound screening for fetal major abnormalities at 11-14 weeks. Acta Obstet Gynecol Scand. 2007;86:666–70.

    Article  PubMed  Google Scholar 

  73. Oztekin O, Oztekin D, Tinar S, Adibelli Z. Ultrasonographic diagnosis of fetal structural abnormalities in prenatal screening at 11-14 weeks. Diagn Interv Radiol. 2009;15:221–5.

    PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Divisions of Fetal Imaging and Pediatric Radiology, Departments of Obstetrics & Gynecology and Radiology, Oakland University William Beaumont School of Medicine, 3601 W 13 Mile Road, Royal Oak, MI, 48073, USA

    Luís F. Gonçalves MD

Authors
  1. Luís F. Gonçalves MD
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Luís F. Gonçalves MD .

Editor information

Editors and Affiliations

  1. Division of Maternal-Fetal Medicine Department of Obstetrics and Gynecology, Wayne State University School of Medicine, Detroit, Michigan, USA

    Jacques S. Abramowicz

Rights and permissions

Reprints and permissions

Copyright information

© 2016 Springer International Publishing Switzerland

About this chapter

Cite this chapter

Gonçalves, L.F. (2016). Three-Dimensional Ultrasound: A Role in Early Pregnancy?. In: Abramowicz, J. (eds) First-Trimester Ultrasound. Springer, Cham. https://doi.org/10.1007/978-3-319-20203-7_13

Download citation

  • DOI: https://doi.org/10.1007/978-3-319-20203-7_13

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-20202-0

  • Online ISBN: 978-3-319-20203-7

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation