DOCSLIB.ORG

First Trimester Anomaly Scan Using Virtual Reality (VR FETUS Study): Study Protocol for a Randomized Clinical Trial C

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text
First Trimester Anomaly Scan Using Virtual Reality (VR FETUS Study): Study Protocol for a Randomized Clinical Trial C Pietersma et al. BMC Pregnancy and Childbirth (2020) 20:515 https://doi.org/10.1186/s12884-020-03180-8 STUDY PROTOCOL Open Access First trimester anomaly scan using virtual reality (VR FETUS study): study protocol for a randomized clinical trial C. S. Pietersma1, A. G. M. G. J. Mulders1, L. M. Moolenaar1, M. G. M. Hunink2,3,4, A. H. J. Koning5, S. P. Willemsen6, A. T. J. I. Go1, E. A. P. Steegers1 and M. Rousian1* Abstract Background: In recent years it has become clear that fetal anomalies can already be detected at the end of the first trimester of pregnancy by two-dimensional (2D) ultrasound. This is why increasingly in developed countries the first trimester anomaly scan is being offered as part of standard care. We have developed a Virtual Reality (VR) approach to improve the diagnostic abilities of 2D ultrasound. Three-dimensional (3D) ultrasound datasets are used in VR assessment, enabling real depth perception and unique interaction. The aim of this study is to investigate whether first trimester 3D VR ultrasound is of additional value in terms of diagnostic accuracy for the detection of fetal anomalies. Health-related quality of life, cost-effectiveness and also the perspective of both patient and ultrasonographer on the 3D VR modality will be studied. Methods: Women in the first trimester of a high risk pregnancy for a fetus with a congenital anomaly are eligible for inclusion. This is a randomized controlled trial with two intervention arms. The control group receives ‘care as usual’: a second trimester 2D advanced ultrasound examination. The intervention group will undergo an additional first trimester 2D and 3D VR ultrasound examination. Following each examination participants will fill in validated questionnaires evaluating their quality of life and healthcare related expenses. Participants’ and ultrasonographers’ perspectives on the 3D VR ultrasound will be surveyed. The primary outcome will be the detection of fetal anomalies. The additional first trimester 3D VR ultrasound examination will be compared to ‘care as usual’. Neonatal or histopathological examinations are considered the gold standard for the detection of congenital anomalies. To reach statistical significance and 80% power with a detection rate of 65% for second trimester ultrasound examination and 70% for the combined detection of first trimester 3D VR and second trimester ultrasound examination, a sample size of 2800 participants is needed. Discussion: First trimester 3D VR detection of fetal anomalies may improve patients’ quality of life through reassurance or earlier identification of malformations. Results of this study will provide policymakers and healthcare professionals with the highest level of evidence for cost-effectiveness of first trimester ultrasound using a 3D VR approach. (Continued on next page) * Correspondence: [email protected] 1Department of Obstetrics and Gynecology, Erasmus MC, University Medical Center Rotterdam, PO Box 2040, 3000 CA Rotterdam, the Netherlands Full list of author information is available at the end of the article © The Author(s). 2020 Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data. Pietersma et al. BMC Pregnancy and Childbirth (2020) 20:515 Page 2 of 10 (Continued from previous page) Trial registration: Dutch Trial Registration number NTR6309, date of registration 26 January 2017. Keywords: First trimester, Two-dimensional ultrasound, three-dimensional ultrasound, Virtual reality, Detection rate, Fetal anomalies Background and completeness [13]. Incomplete ultrasound examin- Congenital anomalies account for 15–20% of all fetal ation may lead to suboptimal care for these women. The deaths and nearly 25% of all neonatal deaths in Europe efforts and costs greater when compared to women with [1]. Around 2% of all pregnancies are affected by a major a BMI < 30 kg/m2. In the first trimester, transvaginal anomaly that requires extensive postnatal support [2]. A ultrasound may be used to overcome limited visibility in correct prenatal diagnosis can direct future parents to the women with an increased BMI. the best possible care. From the above mentioned, we can conclude that According to international and Dutch national postponing detection of anomalies to the second guidelines, all pregnant women are offered a second tri- trimester of pregnancy can be regarded as a missed mester two-dimensional (2D) ultrasound scan to screen opportunity. This is the most compelling argument for fetal anomalies [3–5]. Subsequently, future parents mentioned in international guidelines proposing a first are counseled about the possible diagnosis, prognosis trimester anomaly scan to be offered to all women, and treatment. However, by the end of the first trimes- accompanied by adequate counseling of the potential ter (< 14 weeks gestational age (GA)), a considerable benefits and limitations [14]. However, there is a lack amount of fetal anomalies can already be detected of implementation of the guidelines’ advice in nation- using 2D ultrasound [6, 7]. A systematic review, per- wide screening programs. The available literature con- formed in a high risk population, showed that 61% of cerning detection rates and feasibility of the first the (detectable) anomalies can already be identified by trimester anomaly scan include a low risk population a first trimester anomaly scan [6]. A more recent pro- and are retrospective in design [6]. Prospective or spective cohort study performed in The Netherlands randomized trials for a high risk population are lim- even found a detection rate of 63% within a low risk ited in number. In spite of this, some countries are population, which demonstrates the importance of per- offering a first trimester anomaly scan to their popu- forming a first trimester anomaly scan [8]. The ob- lation [15]. served high detection rate of major anomalies and Over the years several factors have contributed to the ultrasonographic markers coincides with other advan- quality of first trimester 2D ultrasound imaging. The tages. Firstly, detection of an anomaly at an early stage most important ones are the introduction of high fre- in pregnancy provides additional time for counseling, quency ultrasound probes and using the transvaginal ap- advanced genetic testing, parental thought and reflec- proach. The addition of an application providing three- tion [9]. Secondly, a first trimester scan showing no ab- dimensional (3D) renderings have further enhanced first normalities might provide parental reassurance, trimester ultrasound imaging by enabling improved especially in a population at higher risk of fetal anomal- visualization of fetal structures [16]. However, there are ies. Thirdly, if applicable, an early termination of preg- also limitations concerning 3D ultrasound examinations. nancy is considered a low risk procedure, in contrast to The 3D datasets are presented as 3D reconstructions on termination during advanced gestation, which shows a 2D screens. Therefore, the third dimension, depth, can- greater risk of maternal morbidity and mortality [10, not be used to its fullest since the images are being pre- 11]. When pregnant women opt for an early termin- sented on 2D media. Improved visualization can be ation of pregnancy, methods available are considered reached using Virtual Reality (VR) displays. VR enables less invasive when compared to termination at an ad- true depth perception and provides 3D interaction. ‘Ho- vanced stage. Moreover, it has been shown that termin- lograms’ of the 3D ultrasound scans can be created using ation of pregnancy at a more advanced gestational age the V-Scope software (Erasmus MC, Rotterdam, The is associated with an increased risk of an adverse psy- Netherlands), allowing presentation of volumetric data chological outcome [12]. in the best possible way [17, 18]. Following the acquisi- Finally, women with an increased BMI (i.e. > 30 kg/m2) tion of 3D data, using any 3D probe, application of V- could profit from a first trimester anomaly scan. It is scope imaging software enables 3D data to be displayed known that the performance of the second trimester as ‘holograms’ on a 3D display, generating depth percep- transabdominal ultrasound examination in women with tion using 3D glasses. The difference between 2D, 3D an increased BMI is limited with regards to detection and 3D VR is depicted in Fig. 1. These generated Pietersma et al. BMC Pregnancy and Childbirth (2020) 20:515 Page 3 of 10 Fig. 1 Different imaging techniques of the same pregnancy in the first trimester. Images, representing
Load more

Recommended publications
  • GMEC) Strategic Clinical Networks Reduced Fetal Movement (RFM
    Greater Manchester & Eastern Cheshire (GMEC) Strategic Clinical Networks Reduced Fetal Movement (RFM) in Pregnancy Guidelines March 2019 Version 1.3a GMEC RFM Guideline FINAL V1.3a 130619 Issue Date 15/02/2019 Version V1.3a Status Final Review Date Page 1 of 19 Document Control Ownership Role Department Contact Project Clinical Lead Manchester Academic Health [email protected] Science Centre, Division of Developmental Biology and Medicine Faculty of Biology, Medicine and Health, The University of Manchester. Project Manager GMEC SCN [email protected] Project Officer GMEC SCN [email protected] Endorsement Process Date of Presented for ratification at GMEC SCN Maternity Steering Group on:15th February ratification 2019 Application All Staff Circulation Issue Date: March 2019 Circulated by [email protected] Review Review Date: March 2021 Responsibility of: GMEC Maternity SCN Date placed on March 2019 the Intranet: Acknowledgements On behalf of the Greater Manchester and Eastern Cheshire and Strategic Clinical Networks, I would like to take this opportunity to thank the contributors for their enthusiasm, motivation and dedication in the development of these guidelines. Miss Karen Bancroft Maternity Clinical Lead for the Greater Manchester & Eastern Cheshire SCN GMEC RFM Guideline FINAL V1.3a 130619 Issue Date 15/02/2019 Version V1.3a Status Final Review Date Page 2 of 19 Contents 1 What is this Guideline for and Who should use it? ......................................................................... 4 2 What
    [Show full text]
  • ANC Level 1 2Nd Edition.Pdf
    Pregnancy & Childbirth Management Guidelines Level- 1 A Guide for Nurses, Midwives and Doctors Second Edition DEPARTMENT OF WOMAN &CHILD HEALTH DIRECTORATE GENERAL OF PRIMARY HEALTH CARE MINISTRY OF HEALTH SULTANATE OF OMAN 2016 ML- 60 Pregnancy & Childbirth Management Guidelines Level- 1 A Guide for Nurses, Midwives and Doctors Second Edition 2016 I II ACKNOWLEDGEMENT Acknowledgement with gratitude to all contributors & Reviewers for their effort in updating this guideline manual: Contributors from Woman & Child Health Department: • Dr. Jamila Al-Abri, Senior Specialist, Dept. of Woman & Child Health • Dr. Fatima Al Hinai, Senior Specialist, Director of Woman & Child Health Dept. • Dr. Nawal Al Rashdi, Senior Specialist, Dept. of Woman & Child Health • Dr. Salwa Jabbar Alshahabi, Specialist, Dept. of Woman & Child Health • Dr. Omaima Abdel Wahab, Senior Medical Officer, Dept. of Woman & Child Health. Contributors from Primary Health Care Institutions: • Dr. Nabila Al Wahaibi, Senior Consultant (FAMCO), Wadi Kabeer Health Centre. • Dr. Ahdab Abdul Hafeez, Specialist, Muscat Health Centre. • Dr. Imrana Masoud, Senior Medical Officer, Al Seeb Health Centre. Contributors from National Diabetic & Endocrine Centre & NCD department • Dr. Noor Al Busaidi, Senior Consultant, Director of National Diabetic & Endocrine Centre (NDEC) • Dr. Hilal Al Musailhi, Senior Consultant Adult Endocrinology, (NDEC). • Dr. Deepa Manoharan , Medical Officer, (NDEC). • Dr. Nada Hareb Al Sumri, Senior Specialist, Non Communicable Disease Dept • Dr. Suleiman Al Shereigi, Senior Specialist in Public Health Administration,(NDEC) Reviewers from Secondary & Tertiary Heath Care : • Dr. Tamima Al Dughaishi, Senior Consultant Obstetrics & Gynecology, SQUH • Dr. Bernadette Punnoose, Senior Consultant Obstetrics & Gynecology, Royal Hospital • Dr. Badrya Al Fahdi, Senior Consultant Obstetrics & Gynecology, Royal Hospital • Dr. Sumaya Al Amri, Senior Specialist Obstetrics & Gynecology, Royal Hospital • Dr.
    [Show full text]
  • Prenatal Ultrasonography of Craniofacial Abnormalities
    Prenatal ultrasonography of craniofacial abnormalities Annisa Shui Lam Mak, Kwok Yin Leung Department of Obstetrics and Gynaecology, Queen Elizabeth Hospital, Hong Kong SAR, China REVIEW ARTICLE https://doi.org/10.14366/usg.18031 pISSN: 2288-5919 • eISSN: 2288-5943 Ultrasonography 2019;38:13-24 Craniofacial abnormalities are common. It is important to examine the fetal face and skull during prenatal ultrasound examinations because abnormalities of these structures may indicate the presence of other, more subtle anomalies, syndromes, chromosomal abnormalities, or even rarer conditions, such as infections or metabolic disorders. The prenatal diagnosis of craniofacial abnormalities remains difficult, especially in the first trimester. A systematic approach to the fetal Received: May 29, 2018 skull and face can increase the detection rate. When an abnormality is found, it is important Revised: June 30, 2018 to perform a detailed scan to determine its severity and search for additional abnormalities. Accepted: July 3, 2018 Correspondence to: The use of 3-/4-dimensional ultrasound may be useful in the assessment of cleft palate and Kwok Yin Leung, MBBS, MD, FRCOG, craniosynostosis. Fetal magnetic resonance imaging can facilitate the evaluation of the palate, Cert HKCOG (MFM), Department of micrognathia, cranial sutures, brain, and other fetal structures. Invasive prenatal diagnostic Obstetrics and Gynaecology, Queen Elizabeth Hospital, Gascoigne Road, techniques are indicated to exclude chromosomal abnormalities. Molecular analysis for some Kowloon, Hong Kong SAR, China syndromes is feasible if the family history is suggestive. Tel. +852-3506 6398 Fax. +852-2384 5834 E-mail: [email protected] Keywords: Craniofacial; Prenatal; Ultrasound; Three-dimensional ultrasonography; Fetal structural abnormalities This is an Open Access article distributed under the Introduction terms of the Creative Commons Attribution Non- Commercial License (http://creativecommons.org/ licenses/by-nc/3.0/) which permits unrestricted non- Craniofacial abnormalities are common.
    [Show full text]
  • Fetal Medicine August 2010
    Advanced Training Skills Module – Fetal Medicine August 2010 Fetal Medicine This module is designed to prepare the future consultant for dealing with congenital abnormalities detected during pregnancy. This includes the organisation and supervision of screening programmes for structural and chromosomal anomalies. Many of these cases need to be managed within a multidisciplinary team which includes clinical geneticists and fetal medicine subspecialists. Apart from a sound knowledge of embryology and fetal physiology, clinicians working in this field must be competent in the prenatal diagnosis of common abnormalities. They also require a sound working knowledge of clinical and laboratory genetics in order that they can investigate and, where appropriate, refer suitable families. Competence in obstetric ultrasound is a prerequisite for advanced skills in prenatal diagnosis and fetal medicine. Trainees must complete the new Intermediate Ultrasound of Fetal Anatomy module prior to entry into the ATSM in Fetal Medicine. Attendance at a suitable Fetal Medicine theoretical course is a compulsory requirement of the module. This must be attended before completion of the ATSM and can have been done not more than three years previously. Specifically, once trained, individuals should: Work well as part of a multidisciplinary team Understand the organization of prenatal screening and diagnostic services at a local and regional level Be clinically competent in the prenatal diagnosis, counselling and management of common fetal abnormalities and markers of chromosomal abnormality. Be clinically competent and certified in first trimester screening for chromosomal abnormality by a combination of nuchal translucency assessment and biochemical marker assays. Be clinically competent at amniocentesis and have a sound knowledge of the principles and techniques of first trimester chorion villus biopsy.
    [Show full text]
  • Chapter III: Case Definition
    NBDPN Guidelines for Conducting Birth Defects Surveillance rev. 06/04 Appendix 3.5 Case Inclusion Guidance for Potentially Zika-related Birth Defects Appendix 3.5 A3.5-1 Case Definition NBDPN Guidelines for Conducting Birth Defects Surveillance rev. 06/04 Appendix 3.5 Case Inclusion Guidance for Potentially Zika-related Birth Defects Contents Background ................................................................................................................................................. 1 Brain Abnormalities with and without Microcephaly ............................................................................. 2 Microcephaly ............................................................................................................................................................ 2 Intracranial Calcifications ......................................................................................................................................... 5 Cerebral / Cortical Atrophy ....................................................................................................................................... 7 Abnormal Cortical Gyral Patterns ............................................................................................................................. 9 Corpus Callosum Abnormalities ............................................................................................................................. 11 Cerebellar abnormalities ........................................................................................................................................
    [Show full text]
  • Prenatal Prediction of Outcome by Fetal Gastroschisis in a Tertiary Referral Center
    diagnostics Article Prenatal Prediction of Outcome by Fetal Gastroschisis in a Tertiary Referral Center Katharina Nitzsche 1, Guido Fitze 2, Mario Rüdiger 3 and Cahit Birdir 1,* 1 Department of Obstetrics and Gynecology, University Clinic of Carl Gustav Carus Dresden, Technische Universität Dresden, 01307 Dresden, Germany; [email protected] 2 Department of Pediatric Surgery, University Clinic of Carl Gustav Carus Dresden, Technische Universität Dresden, 01307 Dresden, Germany; guido.fi[email protected] 3 Department of Pediatrics, University Clinic of Carl Gustav Carus Dresden, Technische Universität Dresden, 01307 Dresden, Germany; [email protected] * Correspondence: [email protected] Received: 4 June 2020; Accepted: 30 July 2020; Published: 30 July 2020 Abstract: The aim of this study was to find a prenatal parameter to be able to predict possible prenatal complications or postnatal surgical options, thus allowing the fetal medicine specialist, together with pediatric surgeons and neonatologists, to improve the counseling of the parents and to determine the timing of delivery and therapy. This was a retrospective analysis of prenatal diagnosis and outcome of fetuses with 34 cases of gastroschisis between the years 2007 and 2017. A total of 34 fetuses with gastroschisis were examined and 33 outcomes registered: 22 cases of simple gastroschisis (66.7%) and 11 cases of complex gastroschisis (33.3%). A cut-off value of 18 mm for intraabdominal bowel dilatation (IABD) showed a positive predictive value (PPV) of 100% for predicting simple gastroschisis. IABD gives the best prediction for simple versus complex gastroschisis (cut-off of 18 mm). Extra-abdominal bowel dilatation (EABD) cut-off values of 10 mm and 18 mm showed low sensitivity and specificity to predict complex gastroschisis.
    [Show full text]
  • MATERNAL SCREENING for FOETAL ABNORMALITY Assessment Assessment
    REP ORT MATERNAL SCREENING FOR FOETAL ABNORMALITY assessment assessment HEALTH TECHNOLOGY ASSESSMENT UNIT MEDICAL DEVELOPMENT DIVISION health MINISTRY OF HEALTH MALAYSIA MOH/PAK/59.03(TR) 1 MEMBERS OF EXPERT COMMITTEE Dr Zaridah Shafie Obstetric & Gynecology Consultant Kangar Hospital Dr Zulkfili Mohd Kassim Pakar Perunding O & G Hospital Kuala Terengganu Dr Mohd Rouse Abd Majid Obstetric & Gynecology Consultant Sg Petani Hospital Dr Neoh Siew Hong Pediatric Consultant Taiping Hospital Dr Rosnah Sutan Jabatan Kesihatan Bersekutu National University of Malaysia Prof Jamiyah Hassan Faculty of Medicine University Malaya Project Coordinators Dr S Sivalal Deputy Director Health Technology Assessment Unit Ministry of Health Malaysia Dr Rusilawati Jaudin Principal Assistant Director Health Technology Assessment Unit Ministry of Health Malaysia Ms Sin Lian Thye Nursing Sister Health Technology Assessment Unit Ministry of Health Malaysia 2 EXECUTIVE SUMMARY INTRODUCTION Congenital malformations are structural or anatomical defects that are present at birth, resulting from influences acting on the developing embryo in early pregnancy. Some congenital malformations are potentially preventable; however, they remain major causes of early death, hospitalization of infants and young children and significant long-term physical and developmental disabilities. Screening and early detection of Downs Syndrome and other chromosomal anomalies in-utero provides several benefits like the opportunity to inform parents and counseling on the likelihood of delivery
    [Show full text]
  • One Stop Documentation and CTG Monitoring
    From the first day of pregnancy to delivery: One Stop Documentation and CTG Monitoring WEEK 8 WEEK 11 Beginning of Early Pregnancy First Trimester Pregnancy Ultrasound Scan WEEK 36 WEEK 30 WEEK 18 CTG Monitoring Growth Scan Anomaly Scan WEEK 40 CTG Monitoring, Pregnancy Outcomes Delivery Documentation of Room Labour Progress (Partogram) gehealthcare.com/viewpoint From the first ultrasound examination to delivery, ViewPoint™ 6 in combination with Trium CTG Online1 can help you focus on the patient and her baby. Your clinical workflows in the OB/GYN department can now be covered by a single solution. GE offers you a comprehensive solution for digital, paperless documentation throughout pregnancy and birth. ViewPoint 6 was developed to significantly simplify image management, reporting and workflows in hospitals and private practices. Patient data, detailed and structured findings, and images are clearly available in one view. ViewPoint 6 offers examination types for: • Pelvic Ultrasound (including IOTA2) • Growth Scan • Early Pregnancy • Fetal Wellbeing including Biophysical Profile • 1st Trimester Ultrasound including FMF risk assessment2 • Pregnancy Outcome • 2nd/3rd Trimester Ultrasound ViewPoint 6 can be linked to Trium CTG Online1. Trium CTG Online allows you to keep track of all CTG traces, provides decision support and digital archiving and exchange of delivery data for documentation purposes. Trium CTG Online allows to keep your focus on the patient Centralized and Decentralized CTG Monitoring Comprehensive Documentation • Survey
    [Show full text]
  • Guidelines for Professional Ultrasound
    Guidelines For Professional Ultrasound Society and College of Radiographers and British Medical Ultrasound Society Revision 3, December 2018 SCoR/BMUS Guidelines for Professional Ultrasound Practice. Revision 3, December 2018 Minor amendments, March 2019. SOCIETY AND COLLEGE OF RADIOGRAPHERS AND BRITISH MEDICAL ULTRASOUND SOCIETY GUIDELINES FOR PROFESSIONAL ULTRASOUND PRACTICE DECEMBER 2015 Revision 3, December 2018. Minor amendments, March 2019 Contents Acknowledgements ...................................................................................................................................................... 4 Foreword ...................................................................................................................................................................... 6 December 2015 edition ........................................................................................................................................ 6 Revision 1, December 2016 .................................................................................................................................. 6 Revision 2, December 2017 .................................................................................................................................. 7 Revision 3, December 2018. Minor post publication amends March 2019 ....................................................... 7 SECTION 1: GENERAL INFORMATION ........................................................................................................................
    [Show full text]
  • Women's Health and Wellbeing
    INNERMOSTT HE LTHCARE PRIVATE MEDICAL CLINIC Women’s Health and Wellbeing Safe in our hands www.innermosthealthcare.com Welcome from Dr Bryan Beattie Welcome to Innermost Healthcare, the leading private women’s healthcare clinic in Wales. Based at our luxuriously many other scanning only appointed, state-of-the-art companies, you have clinic in Cardiff, we provide immediate access to Dr the very latest in pregnancy Bryan Beattie, Consultant scanning technology and in Fetal Medicine, should “ The extra reassurance expert advice from specialist problems arise. and peace of mind Dr clinicians in genetics and We hope you find this Beattie gave us was maternity care, aesthetics and overview of our services general women’s healthcare helpful and would be worth every penny services. We are passionate delighted to discuss how we ” about delivering the highest can support you whether quality care for women in you are trying to conceive, Wales and the wider UK. currently pregnant or just We believe that a visit to need women’s healthcare. our clinic gives you and your baby the very best of care, by Dr Bryan Beattie providing you with unrivalled MD FRCOG levels of personalised support, Founder and CEO, with access to many scans Innermost Healthcare and tests not available on Chairman of Innermost the NHS at this time. Unlike Learning Charity 2 Innermost Healthcare About us Dr Bryan Beattie MD FRCOG is a Consultant Obstetrician and an accredited Specialist Consultant in Fetal and Maternal Medicine, based at the University Hospital of Wales in Cardiff. In 1995, he was responsible for setting up their Early Pregnancy Assessment Unit.
    [Show full text]
  • Second Trimester Anomaly Scan Using 3D/4D Ultrasound
    DSJUOG Fernando Bonilla-Musoles et al 10.5005/jp-journals-10009-1424 REVIEW ARTICLE Second Trimester Anomaly Scan using 3D/4D Ultrasound 1Fernando Bonilla-Musoles, 2Francisco Bonilla Jr, 3Francisco Raga, 4Oscar Caballero 5Clodoaldo Cadete, 6Luiz Eduardo Machado ABSTRACT ultrasound, such as the 3D/4D and their modes (STIC: The use of three-dimensional/four-dimensional (3D/4D) spatial temporal image correlation; AVC: Automatic ultrasound has become 'universalʼ in the increasingly precise volume calculation; VOCAL: Virtual organ computer- diagnosis of fetal malformations. The introduction of new aided analysis and the inverse mode), more recently the ultrasound modes, such as the HDlive or the Radiance HDlive and Radiance System Architecture (RSA). In System Architecture (RSA), which improve even more the this chapter, we are going to show normal images and quality of images, makes it easier to examine normal embryos and fetuses with incredible perfection and achieve diagnosis curious cases of malformations that have been observed of malformations, increasingly complex and of high clinical recently with the use of 3D/4D, HDlive and RAS. They importance. can demonstrate that these new technologies are Keywords: Three-dimensional/four-dimensional ultrasound, really useful. Fetal malformations, HDlive, Radiance system architecture, Referring to the 3D/4D bibliography, we have only Second trimester. showed quotations by some authors; among us, the most 1-32 How to cite this article: Bonilla-Musoles F, Bonilla F Jr, Raga F, published ones in this field. Concerning the HDlive in Caballero O, Cadete C, Machado LE. Second Trimester Anomaly obstetrics, the literature, even being poor,33-61 is enough Scan using 3D/4D Ultrasound.
    [Show full text]
  • Assessment of Potential of First Trimester Ultrasonography in Detection of Fetal Congenital Structural Malformations- a Retrospective Study
    Original Article ISSN (0): 2347 -338X ; ISSN (P): 2347 -3371 Assessment of Potential of First Trimester Ultrasonography in Detection of Fetal Congenital Structural Malformations- A Retrospective Study 1 2 G Rajesh , Waseem Akhtar 1Associate Professor, Department of Radiology, FH Medical College, Tundla, 2Assistant Professor, Department of Radiology, FH Medical College, Tundla . Abstract Background: Early detection of malformation is tremendously improved with improvement in imaging technology. Yet in a developing country like India majority of pregnant women are not privileged to get timely diagnosis. Present study aimed to assess the potential of first trimester ultrasonography in detection of fetal congenital structural malformations. Subjects and Methods: All pregnant women had anomaly scan and women with fetal structural malformations were included. All patients were screened for congenital anomalies by 11-14 week ultrasound scan (first trimester anomaly scan) as part of routine prenatal care. Second trimester scan was conducted at 18 to 22 weeks gestation. The results of the first trimester anatomic survey were correlated with second trimester target scan to evaluate value of first trimester scan for early detection of anomalies. Results: It showed that out of 924 pregnant women 472 fall under high risk category and 452 under low risk category. Out of 924 women subjected to First Trimester Anomaly Scan 18 patients demonstrated some sort of congenital anomaly whereas Mid Gestation Ultrasound Scan revealed 9 women out of 892 who gave birth to babies with congenital anomaly. Overall only 3% pregnant women revealed congenital anomalies among babies. Conclusion: There is immense need for early diagnosis and timely intervention in the field of prenatal detection of congenital malformation.
    [Show full text]