Jump to ContentJump to Main Navigation
Show Summary Details
More options …

Journal of Perinatal Medicine

Official Journal of the World Association of Perinatal Medicine

Editor-in-Chief: Dudenhausen, MD, FRCOG, Joachim W.

Ed. by Bancalari, Eduardo / Chappelle, Joseph / Chervenak, Frank A. / D'Addario , Vincenzo / Genc, Mehmet R. / Greenough, Anne / Grunebaum, Amos / Konje, Justin C. / Kurjak M.D., Asim / Romero, Roberto / Zalud, MD PhD, Ivica

IMPACT FACTOR 2018: 1.361
5-year IMPACT FACTOR: 1.578

CiteScore 2018: 1.29

SCImago Journal Rank (SJR) 2018: 0.522
Source Normalized Impact per Paper (SNIP) 2018: 0.602

See all formats and pricing
More options …
Volume 43, Issue 2


Novel application of three-dimensional HDlive imaging in prenatal diagnosis from the first trimester

Ritsuko Kimata Pooh
  • Corresponding author
  • CRIFM Clinical Research Institute of Fetal Medicine PMC, Academic Teaching Center of Dubrovnik International University, 7-1-24, Uehommachi Tennoji Osaka, Osaka 543-0001, Japan
  • Email
  • Other articles by this author:
  • De Gruyter OnlineGoogle Scholar
/ Asim Kurjak
Published Online: 2014-07-11 | DOI: https://doi.org/10.1515/jpm-2014-0157


Recent development of three-dimensional (3D) high definition (HD) ultrasound has resulted in remarkable progress in visualization of early embryos and fetuses in sonoembryology. The new technology of HDlive assesses both structural and functional developments in the first trimester with greater reliably than two-dimensional (2D) ultrasound. The ability to visualize not only fetal face, hands, fingers, feet, and toes, but also amniotic membranes, is better with volumetric ultrasound than 2D ultrasound. In this article, detailed and comprehensive structures of normal and abnormal fetuses depicted by 3D HDlive are presented, including various faces of Down’s syndrome and holoprosencephaly, as well as low-set ear and finger/toe abnormalities from the first trimester. Three-dimensional HDlive further “humanizes” the fetus, enables detailed observation of the fetal face in the first trimester as shown in this article, and reveals that a small fetus is not more a fetus but a “person” from the first trimester. There has been an immense acceleration in understanding of early human development. The anatomy and physiology of embryonic development is a field where medicine exerts greatest impact on early pregnancy at present, and it opens fascinating aspects of embryonic differentiation. Clinical assessment of those stages of growth relies heavily on 3D/four-dimensional (4D) HDlive, one of the most promising forms of noninvasive diagnostics and embryological phenomena, once matters for textbooks are now routinely recorded with outstanding clarity. New advances deserve the adjective “breathtaking”, including 4D parallel study of the structural and functional early human development.

Keywords: Fetus; HDlive; prenatal; sonoembryology; three-dimensional; ultrasound


  • [1]

    Bonilla-Musoles F, Esquembre MJ, Bonilla F Jr, Raga F, Machado LE, Caballero O. First trimester. DSJUOG. 2014; in press.Google Scholar

  • [2]

    Bonilla-Musoles F, Raga F, Castillo JC, Bonilla F Jr., Climent MT, Caballero O. High definition real-time ultrasound (HDLive) of embryonic and fetal malformations before week 16. DSJUOG. 2013;7:1–8.Google Scholar

  • [3]

    Grigore M, Cojocaru C, Lazar T. The role of HD live technology in obstetrics and gynecology, present and future. DSJUOG. 2014; in press.Google Scholar

  • [4]

    Hata T, Hanaoka U, Tenkumo C, Sato M, Tanaka H, Ishimura M. Three- and four-dimensional HDlive rendering images of normal and abnormal fetuses: pictorial essay. Arch Gynecol Obstet. 2012;286:1431–5.Web of ScienceGoogle Scholar

  • [5]

    Kagan KO, Pintoffl K, Hoopmann M. First-trimester ultrasound images using HDlive. Ultrasound Obstet Gynecol. 2011;38:607.Google Scholar

  • [6]

    Kurjak A, Azumendi G, Andonotopo W, Salihagic-Kadic A. Three- and four-dimensional ultrasonography for the structural and functional evaluation of the fetal face. Am J Obstet Gynecol. 2007;196:16–28.Google Scholar

  • [7]

    Kurjak A, Miskovic B, Stanojevic M, Amiel-Tison C, Ahmed B, Azumendi G, et al. New scoring system for fetal neurobehavior assessed by three- and four-dimensional sonography. J Perinat Med. 2008;36:73–81.Web of ScienceGoogle Scholar

  • [8]

    Kurjak A, Pooh RK, Merce LT, Carrera JM, Salihagic-Kadic A, Andonotopo W. Structural and functional early human development assessed by three-dimensional (3D) and four-dimensional (4D) sonography. Fertil Steril. 2005;84:1285–99.CrossrefPubMedGoogle Scholar

  • [9]

    Kurjak A, Pooh RK, Tikvica A, Stanojevic M, Miskovic B, Ahmed B, et al. Assessment of fetal neurobehavior by 3D/4D ultrasound. In: Pooh RK, Kurjak A, editors. Fetal neurology. New Delhi: Jaypee Brothers Medical Publishers; 2009. p. 221–85.Google Scholar

  • [10]

    Pooh RK. 3D Sonoembryology. DSJUOG. 2011;5:7–15.Google Scholar

  • [11]

    Pooh RK. Early detection of fetal abnormality. DSJUOG. 2013;7:46–50.Google Scholar

  • [12]

    Pooh RK, Kurjak A. 3D/4D sonography moved prenatal diagnosis of fetal anomalies from the second to the first trimester of pregnancy. J Mater Fetal Neonatal Med. 2012;25:433–55.Web of ScienceCrossrefGoogle Scholar

  • [13]

    Pooh RK, Shiota K, Kurjak A. Imaging of the human embryo with magnetic resonance imaging microscopy and high-resolution transvaginal 3-dimensional sonography: human embryology in the 21st century. Am J Obstet Gynecol. 2011;204:77.e1–16.Web of ScienceGoogle Scholar

About the article

Corresponding author: Ritsuko Kimata Pooh, CRIFM Clinical Research Institute of Fetal Medicine PMC, Academic Teaching Center of Dubrovnik International University, 7-1-24, Uehommachi Tennoji Osaka, Osaka 543-0001, Japan, Tel.: +81-(0)6-6775-8111, Fax: +81-(0)6-6775-8122, E-mail:

Received: 2014-05-10

Accepted: 2014-06-13

Published Online: 2014-07-11

Published in Print: 2015-03-01

Citation Information: Journal of Perinatal Medicine, Volume 43, Issue 2, Pages 147–158, ISSN (Online) 1619-3997, ISSN (Print) 0300-5577, DOI: https://doi.org/10.1515/jpm-2014-0157.

Export Citation

©2015 by De Gruyter.Get Permission

Citing Articles

Here you can find all Crossref-listed publications in which this article is cited. If you would like to receive automatic email messages as soon as this article is cited in other publications, simply activate the “Citation Alert” on the top of this page.

Asim Kurjak, Lara Spalldi-Barišić, Sanja Sibinčić, Selma Porović, Suada Tinjić, and Milan Stanojević
Scripta Medica, 2019, Volume 50, Number 1, Page 35
Ran Neiger
Journal of Clinical Medicine, 2014, Volume 3, Number 4, Page 986
Eberhard Merz and Sonila Pashaj
Journal of Perinatal Medicine, 2017, Volume 45, Number 6
Ritsuko K. Pooh, Kazuo Maeda, Asim Kurjak, Cihat Sen, Alaa Ebrashy, Abdallah Adra, Aliyu Labaran Dayyabu, Tuangsit Wataganara, Renato Augusto Moreira de Sá, and Milan Stanojevic
Journal of Perinatal Medicine, 2016, Volume 44, Number 2

Comments (0)

Please log in or register to comment.
Log in