The use of ultrasound in the management and follow-up of pregnancy has revolutionized maternal perspective of their growing children in utero since 1964. The developing fetus is a challenging and difficult object to evaluate and appreciate for both the mother and the attending midwife or doctor, in part because it is so inaccessible and yet valuable that we both fantasize about its shape, looks, resemblance and size.3D Ultrasound has unraveled this frustration and made it possible for a pregnant lady to feel that she is part of her pregnancy.
Ultrasound has evolved from one-dimensional A scan through to most popular 2 dimensional gray scale real time sonar. Most l mothers do not easily conceptualize the 2 dimensional pictures. Only the attending health professional is able to deduce meaningful information from the picture in a 2D plane. The astonished mother and father have to take home only what the doctor has to tell, which in some cases half of what they wanted to know about their baby.
To the contrary what doctors are looking for in a scan is far different from what the parents to be are looking for. The doctor will concentrate mainly on scientific information that predicts the well being of the child like fetal tone, placental location, the amount of amniotic fluid and fetal heart rate and rhythm. Although equally important to the mother and father, such parameters give very little take home massage to a pregnant couple. Of more importance is the normality of the baby, things such as shape , size, movement and the sex of the baby.
The improvement in computer technology has made it possible to upgrade the ultrasound technology to three dimensional picture (3D) producers, which has added phenomenal revolution in pregnancy care and delivery.
The quality of the picture is enhanced by its multi modal facility and ability to smoothens artifacts, thus rendering a volume of three-dimensional pictorial view of the fetal phenotype. The baby’s face and its resemblance to the family can be appreciated in the days before birth. The presentation of an apparent image of the baby has increased the bonding between the family and the baby long before the baby is born. This is an added advantage to the baby and the caregivers as mothers develop a sense of security and responsibility with added insight into the psychological aspect of their pregnancy, which can encourage the mother to stop potentially harmful habits like smoking in pregnancy as she now feels to be part of the team that is looking after her unborn baby.
Scientific literature has shown that 3-D ultrasound has improved diagnostic efficiency of the doctors and maternal appreciation of what is growing in her womb. These has brought a sense of gratification to both who are interested in the welfare of the fetus as a patient even before it is born.
The mothers can now appreciate the facial looks of the child in utero features such as eyes, nose, mouth are proportionally potrayed like in a ordinary photo. Mothers and Fathers can start assembling a photo album of their baby dating from days before the baby’s birthday.
Fetal sex is one aspect that most couples would like to know during antenatal visits.
Fetal extremities and movements, the numbers of fingers make a reassuring impression to the parents to be about the normality their baby.
Another diagnostic modality is in its ability to show conjectural abnormalities. Mothers and Fathers read a lot about congenitally abnormal babies born some shown on televisions and will invariably ask their attending doctor whether the child is normal or not. With 2D sonar it is rather difficult for one to commit himslf \ herself in answering such a question. 3D pictures can clearly demonstrate structures that enable one to make precise comment about the baby’s morphological appearance.
The sonar became available in South Africa in the beginning of the year 2000.It is the first of its own and the only one in the city, serving a multifaculty purpose in various medical specialties.
With the scarcity of such sonars in the country, a dedicated sonar unit is been established at Medical Chambers, 37A Grobler Street, Polokwane, 0699 .(Phone 015 295 7770) to enhance and improve on already high standard of care they are give to patients.
This 3D facility is linked to the World Wide Web via Internet as the first private tele-medicine facility in the country. Real-time images can either be printed on Polaroid photo paper. Recorded on VHS videotape or sent via internet to the patients PC at home and to the referring physician.
The maximum benefits of the 3D Sonology is best if a patient is between 24 weeks and 34 weeks. This is because at this gestational age, there is enough fluid to act as an acoustic widow to the ultrasound waves to enable acquisition of a better quality image.
The magic 3D cut feature make it possible to remove other artifacts like fetal parts, placental or maternal parts that might observe the fetal anatomy.
The Doppler facilities in the sonar are:
” Power Doppler that amplifies the heart-sounds of the baby. It makes it possible to detect the resistance pulsatility indices of the blood that flows in the baby’s vessels.
This enable t he physician to know whether the baby is getting enough blood with nutrients and oxygen from the mother and the ability of the baby to excrete its waste products to the mother.
The color flow mode show on two colored, green and red for the blood in the blood vessels. Vascular anatomy can be visualized in early embryonic stages. Blood flow and fetal perfusion can be quantified and evaluated, especially for high-risk pregnancy like hypertension. Its angio-mode is the state of the art in the evaluation of the vascular anatomy of the umbilical cord and the placenta. The x-ray mode shows the bony skeleton just like an x-ray but without the biohazard effect of x-ray on the delicate developing baby .This is important in investigating the fetal spine and rule out spinal abnormalities.
In short the advantages of 3D ULTRASOUND are:
- Improved comprehension of fetal anatomy by families.
- Improved maternal fetal bonding.
- Improved identification of suspected or detected abnormalities not seen with 2D using orientations and planes unobtainable with 2D ultrasound.
- Improved recognition of fetal morphology using multiplanar and volume-rendered images.
- Retrospective review and consultation with other specialists after the patient has finished examination using stored images.