The first picture of the baby, right from the mother’s tummy, is a precious memory for future parents. And what could be more spectacular than seeing the baby in motion, and then getting a photo and a DVD at the end?
Well, if for the family 4D ultrasound is of great importance, because it can build and strengthen the relationship with the baby even before it is born, for doctors it is not a “must have”, as gynaecologists can also follow a pregnancy with 3D or even 2D ultrasound.
The notion of imaging comes from the image, not from the imagination … Only on the basis of the image the doctor reaches the diagnosis, and the good news is that ultrasound investigation has no harmful effects on the development of the fetus or mother.
Ultrasound screening for first trimester abnormalities is very important as it can detect serious problems such as pregnancy failure.
The importance of carrying out this investigation is all the greater as some of the detectable problems are incompatible with life and others are constantly accompanied by disability, in these situations there is the option of terminating the pregnancy.
Second trimester abnormality screening ultrasound, also called morphological ultrasound because it involves detailed assessment of fetal morphology (anatomy), provides the family with 3D/4D reconstructed images, making it easier for them to understand aspects of the baby’s face, hands and feet, genital organs, etc. Sometimes it is also easier for the doctor to observe some details using 3D or 4D.
This investigation represents an important medical examination, which requires concentration on the part of the doctor, therefore the specialist should not do 4D just to show the mother how beautiful the fetus is and how it smiles at the mother, losing sight of a possible anomaly.
The 3D/4D examination rarely yields information of medical interest in addition to the 2D examination.
Basically, 3D and 4D are reconstructions, the sonographer makes the acquisition also in 2D from which he makes a reconstruction. 4D is ,actually, a very fast three-dimensional reconstruction so that a few frames appear per second, looking like a video.
Time represents the fourth dimension, i.e. 4D, that’s why you see the fetus in motion.
People want 3D and 4D ultrasounds, but what you see with this technique is what matters most, and pregnant women should go to the doctor for what is to be seen, to make sure the fetus is okay, not 3D or 4D for a picture or a movie.
Ultrasound screening for anomalies in the third trimester of pregnancy also has its purpose because, at this stage, the doctor can evaluate the growth and well-being of the fetus more accurately and with clinical significance, helping the prognosis of the birth.
There are situations when the data provided at this ultrasound may lead to an iatrogenic premature birth (i.e. before term due to a medical benefit/indication) to save the life of the fetus or to a planned birth (even caesarean) to decrease the risks during spontaneous labour.
The great advantage of 3D/4D technology is when you want to study some parts and the fetus is not in a favourable position; handling the acquired and reconstructed volume using 3D/4D technology is like “turning the baby in the tummy”.
This is the great advantage of 3D – 4D technology.
As far as 4D ultrasound is concerned, it has no special indication. Instead, the investigation allows the doctor to have all the data from this acquisition on file, to process and see the details later as well as to send it to another specialist for “second opinion”.
The 4D ultrasound has four dimensions length, height, width, time as opposed to 3D which incorporates the first three without time.
The purpose of ultrasound is to identify certain abnormalities of the fetus and to correctly assess its health, so pregnant women should not ignore this investigation.
It is also important to choose the right professional, i.e. an obstetrician who is highly specialised in fetal ultrasound, with a great deal of experience and thus, has the best chance of identifying fetal abnormalities as quickly as possible.
There are doctors who won’t take the time to look at all the details in ultrasound images. They would show the pregnant woman how the fetus smiles, what his little hands look like, but not do ultrasound of fetal anomalies, screening for anomalies, “morphologies”, even if he has the necessary technology in his office.
There are many gynaecologists who refer pregnant women to doctors with experience in detecting abnormalities, so it is important that they take into account the recommendation and go to a doctor specialized in fetal ultrasounds, because that specialist will know how to identify a fetal abnormality.
