The place of four-dimensional ultrasound in evaluating fetal anomalies

To analyze the capability of four-dimensional surface rendering mode ultrasound (4D SRM USG) in the detection of fetal abnormalities, and also compare it with 2D USG.

A total of 1,379 pregnant women were enrolled in the study, and they all underwent 2D USG screening. In the same session, they were all subsequently screened using 4D USG. The findings of both methods were compared.

A total of 194 fetal anomalies were detected in 176 of 1,379 pregnant women by 2D USG. When all cases, including superficial and non-superficial anomalies, were evaluated together, we found that 2D USG was significantly better than 4D SRM USG in detecting anomalies (p < 0.001). However, 4D SRM USG was superior to 2D USG in terms of image quality, clarity, the distinction between the surrounding structures, and intelligibility among the cases with a superficial anomaly (p < 0.005).

4D USG is superior to 2D USG in detecting malformations related to fetus face, spine, extremities, abdominal wall, and the body surface. However, 4D SRM USG detected only approximately half of the cases with anomalies, and showed a better quality of image in only 15 % of all cases. Therefore, 4D SRM USG may only be suitable for use as a complementary tool in the evaluation of fetal anomalies, especially those of the face, spine, extremity, and abdominal wall.