2D, 3D or 4D ultrasound? Which one is better?

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The impatience to see your baby, which grows directly proportional to the belly, can be “tamed” with the images obtained with the help of the ultrasound.

It offers future parents black-and-white (or, more recently, color) images, in which the child seems to be surrounded by a milky mist. His forehead seems too big, his nose too big… But for parents, these pictures, the first with the little one, are the most beautiful.

For doctors, ultrasounds are the most valuable evidence that the fetus is healthy. And more importantly: the analysis is done without side effects and without radiation! This is because ultrasound is used instead of radiation.

What is ultrasound?

Ultrasound is a non-radiating method, based on ultrasound, through which different anatomical structures are visualized.

Ultrasounds are harmless to the analyzed organs. During pregnancy, ultrasound is used to obtain information about the fetus (its size, position), but also about the placenta and amniotic fluid.

Thus, measurements are made and possible malformations of the fetus can be diagnosed. Since it is a non-invasive method, it can be repeated as often as needed, but at the doctor’s recommendation, not at the request of the future parents.

How many ultrasounds can be done?

Ultrasounds can be done before the 10th week, to confirm the pregnancy, and during the fetal period (after the 10th week), in order to detect any malformations.

As a rule, an ultrasound is done between 11 and 14 weeks and another in the second trimester (18-23 weeks). Between the 28th and the 33rd week, a third ultrasound can be performed.

The doctor recommends it to see how developed the fetus is, how mature the placenta is, as well as to calculate the resistance of the uterine arteries.

These are general recommendations, however. If the doctor considers them useful, he will also indicate other ultrasounds. The American Institute of Ultrasound in Medicine recommends the responsible use of ultrasounds.

It takes 30 minutes

The duration of the examination is at least 30 minutes, in the case of singleton pregnancies, and approximately 60 minutes, in the case of twins.

This interval varies depending on the number of previous ultrasounds and the pathology discovered. There is no need for special preparation or a full bladder.

If the pregnancy is too small, transvaginal ultrasound is indicated. The expectant mother may feel a cold sensation from the gel or a slight pressure on the abdomen. The results are given on the spot, in the form of a bulletin in which certain morphological aspects, the fetal appendages and the functional images obtained through the Doppler examination must be mentioned.

Black and white images are also added, on special paper. Future parents can also receive a CD or a DVD.

With 3D and 4D, facial reconstruction

I’ve left the “2D or 3D” debate to the end. The order of appearance in medical centers was: 2D, 3D and, later, 4D. Regardless of the type of ultrasound, most examinations are done in 2D mode.

That is, through 3D ultrasound, data obtained also from a 2D image is visualized, analyzed and gathered together. 4D means that 3D images are obtained, but in real time. Time is thus the 4th dimension.

3D and 4D ultrasounds are better than 2D only in certain anomalies or for analyzing certain organs. For example, what do 3D and 4D ultrasounds do as opposed to 2D – facial reconstruction. The doctor will opt for a certain type of ultrasound for strictly medical reasons.

Why do errors occur?

2D, 3D, 4D… Regardless of the type, ultrasound can “miss” certain malformations, either due to the use of an inadequate device, or due to fetal or maternal factors (the mother is overweight).

Also, such errors can also occur if the doctor who performs the examination does not have sufficient experience or adequate training. Some malformations can also escape due to the abnormal position of the fetus or an insufficient amount of amniotic fluid.

There are still leaks caused by the natural evolution of malformations. Megabladder is an anomaly that can appear and disappear during pregnancy, and some malformations, such as arachnoid cysts (in the brain area), appear very late in pregnancy.

Thus, at the time of examination, the anomaly has either not yet manifested itself or has disappeared.

Dr. Adrian Mircea Pop, primary physician in radiology and medical imaging, Regina Maria Private Health Network, Bucharest

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An early diagnosis

The introduction of routine fetal ultrasonographic examination has led to an increase in the detection rate of fetal anomalies, and the technical development of equipment, as well as the understanding of fetal anatomy and physiology, has allowed an increase in diagnostic accuracy and early diagnosis of malformations, by 3-6 weeks compared to previous examinations.

In the ultrasonographic examination during pregnancy, the transabdominal or transvaginal approach, three-dimensional ultrasound, spectral Doppler, color or Power-Doppler can be used.

The recommendations are not to use the Doppler method in pregnancies less than 11-12 weeks.

INFO: If the expectant mother is overweight, the doctor may recommend a transvaginal ultrasound.