Umbilical cord evaluation during pregnancy is one if the most important ways of assessing the fetal status , this can either be by Doppler, B-MODE M-MODE and 3d volume mode. Cord anatomy and physiology can be assessed with more precision in3D volume mode. The whole length of the cord can be visualized from fetal origin to placental insertion. Variations in the umbilical cord morphology are clearly shown in 3D and anomalies are easily depicted.
Aberrations like Velamntous insertion, Succenturiate placentation, True umbilical cord knot and umbilical cord compression of one of the limbs can be seen clearly in a 3D SONAR. Distressing and potentially dangerous situation is umbilical cord which is around the neck, this situation if not discovered while the woman is still pregnant may cause intrapartum death or even antenatal death if is get tightly strangled around the neck and cause total obstruction of the blood flow to the baby.
In 3D this can be seen while the baby is still in the womb and preventive measures like elective Caesarean section can be planned and the baby’s life be saved.
The picture below shoes a 32 weeks baby with umbilical cord around the neck. With close monitoring an elective C/Section was done at 37 completed weeks and a life 3,9kgh male baby was delivered.
In a sad situation nowhere the cord was not seen during pregnancy due to lack of 3D ULRASOUND facilities, unexpected and unwanted outcome are the usual results like in the picture below.
This baby was 36 weeks with no antenatal problems but a cord which was 5 times around the neck was missed on 2D sonar and a 3.4kg baby was deliver dead at 39 week.
In conclusion a THREE DIMENSIONAL ULTRASOUND can generate a high quality three-dimensional images of the umbilical cord and is in the modern days a very useful tool in the routine assessment of pregnancy.
The first three dimensional facility in AFRICA was in SOUTH AFRICA at Our Practice.