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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

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Volume 45, Issue 6


Advantages of 3D ultrasound in the assessment of fetal abnormalities

Eberhard Merz / Sonila Pashaj
  • Center for Ultrasound and Prenatal Medicine, Frankfurt, Germany
  • Maternity Hospital Koco Gliozheni, Tirana, Albania
  • Other articles by this author:
  • De Gruyter OnlineGoogle Scholar
Published Online: 2017-02-03 | DOI: https://doi.org/10.1515/jpm-2016-0379


Three-/four-dimensional (3D/4D) imaging enables a more detailed survey of the embryo and the fetus compared to two-dimensional (2D) ultrasound. The availability of several display modes and standardized examinations permits the demonstration of both the normal and abnormal fetal anatomy in controlled planes and rendered images from different angles. This allows the demonstration of even subtle fetal defects in an ideal sectional plane in a precisely rendered surface or transparent image viewed from an optimal angle. When counseling the parents, the rendered images can help them understand the severity of an existing malformation or, conversely, ensure them of the absence of any fetal abnormality. This is particularly useful in cases with an increased recurrence risk of a specific fetal malformation.

Keywords: 3D Ultrasound; 4D ultrasound; fetal malformations; prenatal diagnosis


  • [1]

    Merz E. 25 years of 3D ultrasound in prenatal diagnosis (1989–2014). Ultraschall Med. 2015;36:3–8.Web of ScienceGoogle Scholar

  • [2]

    Benacerraf BR, Benson CB, Abuhamad AZ, Copel JA, Abramowicz JS, Devore GR, et al. Three- and 4-dimensional ultrasound in obstetrics and gynecology: proceedings of the American Institute of Ultrasound in Medicine Consensus Conference. J Ultrasound Med. 2005;24:1587–97.CrossrefGoogle Scholar

  • [3]

    Merz E, Abramowicz JS. 3D/4D ultrasound in prenatal diagnosis: is it time for routine use? Clin Obstet Gynecol. 2012;55:336–51.Web of ScienceCrossrefGoogle Scholar

  • [4]

    Kurjak A, Miskovic B, Andonotopo W, Stanojevic M, Azumendi G, Vrcic H. How useful is 3D and 4D ultrasound in perinatal medicine? J Perinat Med. 2007;35:10–27.Web of ScienceCrossrefGoogle Scholar

  • [5]

    Dyson RL, Pretorius DH, Budorick NE, Johnson DD, Sklansky MS, Cantrell CJ, et al. Three-dimensional ultrasound in the evaluation of fetal anomalies. Ultrasound Obstet Gynecol. 2000;16:321–8.CrossrefGoogle Scholar

  • [6]

    Merz E, Bahlmann F, Weber G. Volume (3D) scanning in the evaluation of fetal malformations – A new dimension in prenatal diagnosis. Ultrasound Obstet Gynecol. 1995;5:222–7.CrossrefGoogle Scholar

  • [7]

    Merz E, Welter C. 2D and 3D ultrasound evaluation of normal and abnormal fetal anomaly in the second and third trimesters in a level III center. Ultraschall Med. 2005;26:9–16.CrossrefGoogle Scholar

  • [8]

    Merz E. Current 3D/4D ultrasound technology in prenatal diagnosis. Eur Clinics Obstet Gynaecol. 2005;1:184–93.CrossrefGoogle Scholar

  • [9]

    Benacerraf BR, Shipp TD, Bromley B. Three-dimensional US of the fetus: volume imaging. Radiology 2006;238:988–96.CrossrefGoogle Scholar

  • [10]

    Merz E, Benoit B, Blaas HG, Baba K, Kratochwil A, Nelson T, et al. Standardization of three-dimensional images in obstetrics and gynecology: consensus statement. Ultrasound Obstet Gynecol. 2007;29:697–703.CrossrefWeb of ScienceGoogle Scholar

  • [11]

    Benoit B, Chaoui R. Three-dimensional ultrasound with maximal mode rendering: a novel technique for the diagnosis of bilateral or unilateral abence or hypoplasia of nasal bones in second-trimester screening for Down syndrome. Ultrasound Obstet Gyneco1. 2005;25:19–24.Google Scholar

  • [12]

    Pashaj S, Merz E. Detection of fetal corpus callosum abnormalities by means of 3D ultrasound. Ultraschall Med. 2016;37:185–94.Web of ScienceGoogle Scholar

  • [13]

    Merz E, Weber G, Bahlmann, Miric-Tesanic D. Application of transvaginal and abdominal three-dimensional ultrasound for the detection or exclusion of malformations of the fetal face. Ultrasound Obstet Gynecol. 1997;9:237–43.CrossrefGoogle Scholar

  • [14]

    Lee W, McNie B, Chaiworapongsa T, Conoscenti G, Kalache KD, Vettraino IM, et al. Three-dimensional ultrasonographic presentation of micrognathia. J Ultrasound Med 2002;21:775–81.CrossrefGoogle Scholar

  • [15]

    Dagklis T, Borenstein M, Peralta CF, Faro C, Nicolaides KH. Three-dimensional evaluation of mid-facial hypoplasia in fetuses with trisomy 21 at 11 + 0 to 13 + 6 weeks of gestation. Ultrasound Obstet Gynecol. 2006;28:261–5.Google Scholar

  • [16]

    Merz E. 3D ultrasound in prenatal diagnosis. In: Merz E, editor. Ultrasound in obstetrics and gynecology, Vol 1: Obstetrics. New York and Stuttgart: Thieme; 2005, pp. 516–528.Google Scholar

  • [17]

    Merz E, Miric-Tesanic D, Welter C. Value of the electronic scalpel (cut mode) in the evaluation of the fetal face. Ultrasound Obstet Gynecol. 2000;16:564–8.CrossrefGoogle Scholar

  • [18]

    Pooh RK, Kurjak A. Novel application of three-dimensional HDlive imaging in prenatal diagnosis from the first trimester. J Perinat Med. 2015;43:147–58.Web of ScienceCrossrefGoogle Scholar

  • [19]

    Merz E. Surface reconstruction of a fetus (28+2 GW) using HDlive technology. Ultraschall Med. 2012;33:211–12.Web of ScienceCrossrefGoogle Scholar

  • [20]

    Andresen C, Matias A, Merz E. Fetal face: the whole picture. Ultraschall Med. 2012;33:431–40.Web of ScienceCrossrefGoogle Scholar

  • [21]

    Pretorius DH, House M, Nelson TR, Hollenbach KA. Evaluation of normal and abnormal lips in fetuses: comparison between three- and two-dimensional sonography. Am J Roentgenol. 1995;165:1233–7.CrossrefGoogle Scholar

  • [22]

    Lee W, Kirk JS, Shaheen KW, Romero R, Hodges AN, Comstock CH. Fetal cleft lip and palate detection by three-dimensional ultrasonography. Ultrasound Obstet Gynecol. 2000;16:314–20.CrossrefGoogle Scholar

  • [23]

    Rotten D, Levaillant JM. Two-and three-dimensional sonographic assessment of the fetal face. 2. Analysis of cleft lip, alveolus and palate. Ultrasound Obstet Gynecol. 2004;24:402–11.CrossrefGoogle Scholar

  • [24]

    Mittermayer C, Blaicher W, Brugger PC, Bernaschek G, Lee A. Foetal facial clefts: prenatal evaluation of lip and primary palate by 2D and 3D ultrasound. Ultraschall Med 2004;25:120–5.CrossrefGoogle Scholar

  • [25]

    Levaillant JM, Nicot R, Benouaiche L, Couly G, Rotten D. Prenatal diagnosis of cleft lip/palate: the surface rendered oro-palatal (SROP) view of the fetal lips and palate, a tool to improve information-sharing within the orofacial team and with the parents. J Craniomaxillofac Surg. 2016;44:835–42.CrossrefGoogle Scholar

  • [26]

    Merz E, Pashaj S. Prenatal detection of orofacial clefts. Ultraschall Med. 2016;37:133–5.CrossrefGoogle Scholar

  • [27]

    Merz E, Pashaj S. Current role of 3D/4D Sonography in obstetrics and gynecology. DSJUOG 2013;7:400–8.CrossrefGoogle Scholar

  • [28]

    Campbell S, Lees C, Moscoso G, Hall P. Ultrasound antenatal diagnosis of cleft palate by a new technique: the 3D ‘reverse face’ view. Ultrasound Obstet Gynecol 2005;25:12–8.CrossrefGoogle Scholar

  • [29]

    Benacerraf BR, Sadow PM, Barnewolt CE, Estroff JA, Benson C. Cleft of the secondary palate without cleft lip diagnosed with three-dimensional ultrasound and magnetic resonance imaging in a fetus with Fryns’ syndrome. Ultrasound Obstet Gynecol. 2006;27:566–70.CrossrefGoogle Scholar

  • [30]

    Pilu G, Segata M. A novel technique for visualization of the normal and cleft fetal secondary palate: angled insonation and three-dimensional ultrasound. Ultrasound Obstet Gynecol. 2007;29:166–9.Web of ScienceCrossrefGoogle Scholar

  • [31]

    Faro C, Benoit B, Wegrzyn P, Chaoui R, Nicolaides KH. Three-dimensional sonographic description of the fetal frontal bones and metopic suture. Ultrasound Obstet Gynecol. 2005;26:618–21.CrossrefGoogle Scholar

  • [32]

    Helfer TM, Peixoto AB, Tonni G, Araujo Júnior E. Craniosynostosis: prenatal diagnosis by 2D/3D ultrasound, magnetic resonance imaging and computed tomography. Med Ultrason. 2016;18:378–85.CrossrefWeb of ScienceGoogle Scholar

  • [33]

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

  • [34]

    DeVore GR, Falkensammer P, Sklansky MS, Platt LD. Spatio-temporal image correlation (STIC): new technology for evaluation of the fetal heart. Ultrasound Obstet Gynecol. 2003;22:380–7.CrossrefGoogle Scholar

  • [35]

    Chaoui R, Hoffmann J, Heling KS. Three-dimensional (3D) and 4D color Doppler fetal echocardiography using spatio-temporal image correlation (STIC). Ultrasound Obstet Gynecol. 2004;23:535–45.CrossrefGoogle Scholar

  • [36]

    Paladini D, Vassallo M, Sglavo G, Lapadula C, Martinelli P. The role of spatio-temporal image correlation (STIC) with tomographic ultrasound imaging (TUI) in the sequential analysis of fetal congenital heart disease. Ultrasound Obstet Gynecol. 2006;27:555–61.CrossrefGoogle Scholar

  • [37]

    Pooh RK, Maeda K, Kurjak A, Sen C, Ebrashy A, Adra A, et al. 3D/4D sonography – any safety problem. J Perinat Med. 2016;44:125–9.Web of ScienceCrossrefGoogle Scholar

  • [38]

    Charach R, Abramowicz J, Shoham-Vardi I, Sheiner E. “Is it safe for my baby?” acoustic exposure of diagnostic ultrasound. Harefuah 2011;150:588–92.Google Scholar

About the article

Received: 2016-11-25

Accepted: 2016-12-20

Published Online: 2017-02-03

Published in Print: 2017-08-28

Author’s Statement

Conflict of interest: Authors state no conflict of interest.

Material and methods: Informed consent: Informed consent has been obtained from all individuals included in this study.

Ethical approval: The research related to human subject use has complied with all the relevant national regulations, and institutional policies, and is in accordance with the tenets of the Helsinki Declaration, and has been approved by the authors’ institutional review board or equivalent committee.

Citation Information: Journal of Perinatal Medicine, Volume 45, Issue 6, Pages 643–650, ISSN (Online) 1619-3997, ISSN (Print) 0300-5577, DOI: https://doi.org/10.1515/jpm-2016-0379.

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Asim Kurjak
Journal of Perinatal Medicine, 2017, Volume 45, Number 6

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