The New World of Fetal Ultrasounds

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A Different View

For years ultrasound images have been two-dimensional (2D), and the physician and/or sonographer would take these images and imagine how they would look in 3D. With the new advances in technology, 4D ultrasounds are now possible.

Dr. Ngozi Osuagwu, an OB-GYN and author of Letters to My Sisters—Plain Truths and Straightforward Advice From a Gynecologist, says with the new technology, they can take a 2D image and slice the images to see it in 3D on the screen. "We can manipulate the images in different angles," says Dr. Osuagwu. "With four-dimensional (4D) we can see the images immediately as we are scanning the patient."

Dr. Osuagwu says that 3D and 4D ultrasound is still new technology at this time and not widely available, though that is changing. "3D and 4D ultrasonography is still new technology in most places and does not represent the standard of care," says Dr. Osuagwu. "Patients have to realize that the images they get may not look like the ones seen on television. Less than 20 percent get those kinds of images in the physicians' offices."

Improving Prenatal Care

Dr. Osuagwu says the traditional 2D ultrasound will most likely remain the standard in diagnostic ultrasound studies used by physicians. If problems are suspected then the 3D and 4D ultrasounds will be ordered."Diagnostic 3D/4D ultrasound is utilized by physicians to better visualize the fetal heart and to identify any surface and spinal anomalies," says Dr. Osuagwu. "As with all technology it is an advancement and furthers our understanding in managing the care of the unborn child."

Lori Crits, a registered nurse and the program director of ultrasound education for the OB-GYN residency at Doctors Hospital in Columbus, Ohio, believes 3D imaging gives healthcare professionals more options when it comes to prenatal health. "Being able to see in the third dimension allows us to see defects that we were not able to see clearly before," says Crits. "We can look at a profile and see markers for Down syndrome or a variety of other malformations and syndromes."

Crits says there are two critical times during your pregnancy that ultrasound should be done: One in the first trimester to provide your doctor with accurate dates and another at 19 to 21 weeks. This is a very important scan and should be done only be a skilled sonographer, trained, and registered in OB-GYN. "This is called the anatomy scan," says Crits. "We call it this because this is the best time to make sure the fetus is developing the way it should be. All of the fetal anatomy is looked at and evaluated."

These new 3D and 4D images can detect many things that weren't visible before. Cleft lip, heart defects, bone dysplasias, facial abnormalities, and many other conditions can be caught and possibly treated or prepared for much earlier.

Bonding in 4D

Yvette Deluca from Glendale, Arizona, noticed that while the 3D ultrasounds didn't make her feel any closer to the baby, it definitely made a difference to her husband. "I noticed after the ultrasound he started talking to the baby and rubbing my tummy more often," says Deluca. "It wasn't 'How are you feeling?' anymore. It became, 'How are you two feeling?' and 'Do the two of you need anything?' He was more aware of both of us. He took the ultrasound pictures and hung them up at work."

Deluca says the picture made the pregnancy more concrete for her two older daughters as well. "They both wanted copies to carry back and forth to school and to their father's house," she says. "Both of them showed their father and stepmom and friends."

It is for this reason that imaging centers are popping up around the US with increasing regularity. Linda Kreuzer, a registered nurse and co-owner of the Already Adorable Prenatal Imaging Center in Tucson, says watching people see their own babies in 3D and 4D is amazing. "I have seen macho dads weep when they see their unborn baby for the first time," says Kreuzer. "I've heard large extended families shout with joy at watching a baby yawn and stretch. Others have reported dads kissing the screen or their partner's abdomen in an ecstasy of recognition and pleasure."

The Safety Factor

Though the American Institute of Ultrasound in Medicine(AIUM) and the American College of Obstetricians and Gynecologists (ACOG) discourage the use of obstetric ultrasonography for nonmedical purposes, most experts agree that in the many years since ultrasound technology has been regularly used, there have been no safety issues. "I would encourage any expectant parent interested in obtaining a 3D/4D ultrasound to choose a facility that demonstrates safe and responsible practices and scanning guidelines," says Kreuzer. She says these facilities will only scan clients who are under the care of an obstetrician or nurse/midwife and have already had their diagnostic ultrasound and will request verification of this.