Related Experiment Video
Updated: Aug 15, 2026
Fetal Mouse Cardiovascular Imaging Using a High-frequency Ultrasound (30/45MHZ) System
Published on: May 5, 2018
Maternal severe obesity and sonographic visualization of fetal anatomy
Faith Dunn1, Matthew Finneran1, Ralitza Peneva1
1Department of Obstetrics and Gynecology Medical University of South Carolina Charleston South Carolina USA.
Objective:
We sought to investigate adequacy of fetal anatomic visualization in pregnant patients with BMI ≥ 50 kg/m2 during second trimester fetal anatomic survey.
Methods:
This was a retrospective chart review of singleton pregnancies presenting for fetal anatomic survey from 18 0/7 to 21 6/7 weeks gestation between January 2019 and December 2020 at a single tertiary care center. The primary outcome was rate of anatomic survey completion stratified by body mass index (BMI) category, as defined by the World Health Organization. Severe obesity was defined as BMI ≥50 kg/m2. Secondary outcomes included scan duration, number of images acquired, and adequacy of visualization of individual organ systems. Logistic regression was used to generate an adjusted odds ratio (aOR) for anatomic survey completion compared to the normal BMI referent group.
Results:
Of 2372 anatomic surveys, 9.0% of patients were normal weight, 31.5% of patients were overweight, 54.7% of patients were obese (26.0% class I, 15.9% class II, 12.2% class III), and 4.8% of patients were with severe obesity. Rates of anatomic survey completion were highest in normal weight patients, and lowest in those with severe obesity (67.6% vs. 4.4%, p < .001). Severe obesity impacted visualization of all organ systems; cardiac structures were most affected compared to normal-weight individuals (75.1% vs. 8.7%, p < .001). Compared to patients with normal BMI, there are significantly reduced odds of anatomic survey completion in patients with class I obesity (aOR 0.70, 95% CI 0.50-0.98), class II obesity (aOR 0.42 95% CI 0.30-0.61), class III obesity (aOR 0.13, 95% CI 0.08-0.19), and severe obesity (aOR 0.02, 95% CI 0.01-0.05). The median exam duration and number of images acquired decreased with increasing BMI (ranging between 33.5-28.4 min and 86-63 images).
Conclusions:
Patients with severe obesity have extremely low rates of anatomic survey completion at the first attempt. The inability to adequately evaluate fetal anatomy in this patient population is especially concerning due to the higher baseline risk of fetal anomalies with increasing obesity. The healthcare disparity demonstrated in this data justifies further research on advancements in practice standards and technology in obstetric imaging.
