Assessment of fetal anatomy in the first trimester using two- and three-dimensional ultrasound

The objective of this study was to perform a complete anatomical survey of the fetus at 12-13 weeks gestation using stored volumes acquired by a three-dimensional (3D) scanner. 159 consecutive women at 12-13 weeks gestation who had a routine early pregnancy scan in our unit were recruited. A complete survey of the fetal anatomy was attempted by two-dimensional (2D) transabdominal and, if needed, transvaginal ultrasound. Then, using a 3D transvaginal probe, two volumes of the whole fetus were acquired. A complete anatomical survey (excluding anatomy of the heart) was attempted using the stored data. A complete anatomical survey was achieved in 93.7% (149) of cases with 2D ultrasound compared to 80.5% (128) of cases with 3D volume acquisition (p<0.001). The nuchal translucency was measured with 2D scanning in 98.7% of cases and in 91.8% of cases using 3D volumes. The mean time to perform a 2D scan was 12.2 min standard deviation (SD 3.4 min) while the mean time to obtain and examine the stored volumes was 8.4 min (SD 1.45 min, p<0.001). Real-time 2D ultrasound is still the best way to examine fetal anatomy in the first trimester. However, 3D ultrasound can be a useful addition to clinical practice, providing views not easily obtained by conventional 2D ultrasound. It can potentially minimize actual scanning time and provides an excellent way to store scanned data.