The 4D Ultrasound is a new technology in ultrasound which facilitates picturing the fetus with a real time image.
The main goal of a fetal ultrasound anomaly scan using 4D ultrasonography is, to provide accurate information which will facilitate the delivery of optimized antenatal care with the best possible outcomes for mother and fetus.
Different terms for the examination
- Anomaly screening
- 2nd level fetal ultrasound
- 4D fetal ultrasound
Indications and timing for the 4D scan:
- Confirm pregnancy and it’s location.
- Confirms viability.
- Confirm gestational age (GA) of the fetus, and establish the expected due date (EDD), in case of patients who are unsure of dates for their last menstrual period, or with history of irregular menses before pregnancy.
- Confirm the number of pregnancy, and in case of multiple pregnancies; evaluation of the chroionicity and amnionicity, (dichorionic / mono chorionic … etc), in other words (identical and non-identical twins).
** 1st trimester anomaly scan (11 weeks + 6 days- 13 weeks + 6 days)
- Checking the fetus for major congenital anomalies (structural defects), and soft markers; increasing the risk for the likehood of fetal chromosomal aneuploidy (eg. Down syndrome)
- Evaluation of the cervix, to screen for patients at risk to develop abortion or preterm labour.
2nd trimester anomaly scan:
- Fetal growth assessment and pattern.
- Fetal Doppler (blood circulation to the fetus).
- Assessment of the amniotic fluid.
- Placental evaluation: in case of low lying placenta / placenta Previa, further trans-vaginal ultrasound is done, to confirm location, screen for adherent placenta, scheduling for follow up for placental re- evaluation.
- Checking for structural defects, congenital anomalies, and soft markers for chromosomal anomalies.
- 1st trimester ultrasound is done, through a transabdominal approach, and continued with a transvaginal ultrasound for cervical assessment.
- 2nd trimester ultrasound is done through transabdominal approach. In case of low lying placenta transvaginal approach is done to complete the evaluation of the placenta.
4D and 3D ultrasound, is a new technology employed to visualize the uterus, uterine cavity and ovaries in special planes, and in 3D and 4D images.
Gynecologists usually refer the patients, to confirm and further assess, some uterine or ovarian lesions seen by regular 2D ultrasound.
Different terms for the examination
- 2nd level gynecological ultrasound
- 3D/ 4D gynecological ultrasound
- Uterine anomalies.
- Infertility: to evaluate the uterus, endometrial cavity and ovaries.
- Endometrial lesions, eg: endometrial polyp.
- Myometrial lesions, eg: fibroids,adenomyosis.
- Ovarian lesions, eg: cysts, tumors, chocolate cysts.
- In married women: it’s done through transvaginal approach +/- transabdominal approach. With an empty urinary bladder.
- In cases of virgin female: it’s done through a transabdominal approach. With a full urinary bladder.
Special ultrasound scans:
Doppler ultrasound of pregnancy
- Confirm gestational age (GA) of the fetus, and establish the expected due date (EDD), in case of patient’s with unsure of dates for their last menstrual period, or with history of irregular menses before pregnancy.
- Discordance in the fetal growth with the gestational age (small for gestation/ large for gestation).
- Increased or reduced amount of amniotic fluid, for gestational age.
- Maternal diseases; eg. Diabetes (pregestational/ gestational), pregnancy induced hypertension and pre-eclampsia.
Report (Items to be checked)
- Fetal growth pattern.
- Doppler assessment of blood flow to the fetus.
- Amount of liquor measurement.
- Biophysical profile.