Objective: This study was conducted trying to answer the question whether three-dimensional ultrasound imaging should be used routinely for prenatal screening of congenital malformations or only used selectively for specific high risk women for congenital malformations.
Subjects & Methods: This study included 1000 pregnant women between 14 and 32 weeks gestation, Routine ultrasound examination was done during antenatal care of 500 pregnant women with no history of risk factors of congenital malformation, their ages were < 35 y (group 1). Selective ultrasound examination was indicated for screening of 500 pregnant women with history of one or more risk factors for getting malformed babies (group 2). Serial ultrasound examinations were done for assessment of fetal organs, first using transabdominal traditional 2-D ultrasound imaging, then 3-D ultrasound examinations using the same machine.
Results: On routine antenatal examinations of group (1) there was no significant difference in detection of congenital malformations between 2-D and 3-D ultrasound examinations (0.2 % and 0.6 % respectively, P > 0.05). On the other hand, there was no significant difference between selective 2-D and 3-D ultrasound examinations of high-risk group (11) (0.8 % and 1.4 % respectively, P > 0.05). There was no significant difference between routine and selective ultrasound use for detection of congenital malformations (P> 0.05). Three-dimensional ultrasound provided the same informations as 2-D ultrasound imaging in 33.33% (1/3 diagnosed anomalies) of group (1) and 57.14% (4/7 anomalies) of group (11). Whereas it was more accurate in diagnosis of fetal anomalies than 2-D imaging in 66.66% (2/3 anomalies) of group (1) and 42.85%(3/7 anomalies) of group (2.).These results were not statistically significant (P>0.05).
Conclusion: Many fetal malformations could be diagnosed by traditional 2-D ultrasonography, yet in some cases limitations do exist. Therefore, a high degree of expertise and training is needed. Traditional 2-D ultrasonography was used routinely early and late in pregnancy for other obstetric indications. We do not support the routine use of 3-D ultrasonography during antenatal assessment of the pregnant women . The adjunctive use of 3-D ultrasonographic imaging system with the 2-D imaging in selective cases can greatly increase diagnostic accuracy of congenital malformation. On the other hand, It is equally important to weigh the human costs against the benefit.