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Technology is an important factor in the medical fraternity. Moreover, the high rate of technological change has brought many measures in the field of medicine. One sector that has been affected by technology is obstetrics and gynecology in which ultrasound imaging plays an important role. Ultrasound employs the use of sounds to create an image depicting the development inside the body. The ultrasound scanner sends the sound waves into the body and when the sound bounces back, the sound produces an image on the computer screen.
This is amplified by the use of the 3D/4D ultrasound that can amass volume of echoes, store it digitally and shade producing images of fetus and adds an element of movement. Thus, this enables the activity and state of the fetus to be easily analyzed. Therefore, the aim of this paper is to analyze the benefits of 3D/4D ultrasound imaging in the field of obstetrics and gynecology.
The technology of ultrasound has played an important diagnostic role in the field of obstetrics because it employs sound waves to form images replacing ionizing methods e.g. x-ray to receive the same information. It has replaced the 2D that has been in place for a long time that showed white and black, grainy and flat images that require an expert to interpret the given results. However, the introduction of the 3D ultrasound added depth dimensions that made the photographic image clearer, and the image is easily interpreted by the untrained eye. The inclusion of the 4D ultrasound ensures capturing of movement of the given fetus (DeVore & Platt, 2004). Thus, the use of 3D and 4D ultrasound has made it cheaper for the information to be achieved and at the same time reduces the time that the results will be obtained (return time).
The 3D and 4D volume sonography usually provides useful diagnostic information for evaluation by gynecologists especially in the uterine duplication anomalies and evaluation of the uterine cavity. Utilization of the 3D and 4D ultrasound in the assessment of the fetal anomalies predicts prenatal characterization of the fetus congenital defects e.g. skeletal and facial anomalies. The information that is obtained from this exam assists the health care providers in counseling parents on the development of the fetus especially in the nature of anomalies, prognosis, and the postnatal consideration of the congenital abnormalities.
2D sonography plays an important role in imaging, but the inclusion of surface rendering (multi-planar reconstruction) in the 3D image has played an important role in the fetal face. This is because the acquisition of fetal face volume can be easily used to reconstruct the midline sagittal plane; a phenomenon that lacked in other techniques e.g. 2D. Such information is crucial in evaluating the fetal nasal bone or evaluation of suspected micrognathia cases. Moreover, the information that is available from the surface-rendered and multi-planar views from the collected data of fetal face helps in explaining a suspected palate or cleft lip and/or any possible mental and orbital abnormalities.
Some expert physicians have utilized the 3D ultrasound fetal imaging in fetal echocardiography. The utilization of volume data in reconstructing the image of the heart has enabled the analysis of normal cardiac structures. Standardized planes of the given fetal heart can be constructed from the sonographic data reducing operator dependence. The fetal heart volumes can be easily acquired in real-time with the help of gated technology and can be stored as a cine loop of the given cardiac cycle.
Thus, surface rendering image capabilities have ensured that the dependence towards the operator has been drastically reduced. 3D color capability also plays an important role in extra-cardiac vasculature assessment. This technique ensures that the fetal placental cord insertion site images can be produced. Moreover, other information such as the vascular anastomoses, abnormal vessels from the pulmonary sequestration, and the aberrations of the central nervous system can be easily known.
The capability of the 3D and 4D ultrasound in storing volume data plays an important role after the patient has left the examination site. The data that was obtained during the examination procedure can be manipulated and reconstructed in any orientation for interpretation. Nevertheless, it is quick to store a single volume of data, and the same data permits interpretation of the scanned region in a variety of planes.
This capability ensures improved patient throughput and promotes a more efficient ultrasound practice. The stored information can be easily electronically transmitted for better interpretation and evaluation promoting the use of teleradiology in improving image interpretation and at the same time decreasing the dependency of the operator. Thus, it enables the utilization of ultrasound technology in remote areas where an ultrasound expert is absent.
The three and four-dimensional images play an important role in the psychological perspective of the parent towards the fetus. A patient who utilizes volume sonography and views the 3D/4D images enhances the bond between them and the fetus. Moreover, the parents have a positive feeling towards the developing fetus. Even though 2D offers the same functionality, but the 3D/4D image offers more satisfaction.
In certain circumstances, the 3D and 4D images can be used in providing keepsake images of the maturing fetus to its parents. When the parents, friends, and other family members view the features, movements, and facial expressions of the fetus they try to recreate resemblance of the fetus (baby) with the people around the family creating a bond at a time that the pregnancy is some few months old (Jurgens & Chaoui, 2003). Thus, the visualization of the fetus enables an unparalleled bonding experience involving parties involved. Moreover, the fetal visualization may at times alleviate maternal depression and anxiety, and at the same time enables the father to feel that he is connected to the pregnancy hence, strengthening the bond between the father and the child.
Bio-effects should be placed into consideration when utilizing ultrasounds since it is a form of energy. Ultrasound has two common effects in tissues, which include mechanical and heating. However, 2D ultrasound has no harmful effects through studies that have been carried out in epidemiology. Since the 3D and 4D ultrasound involves reconstructions of the 2D images, the energy that is released is to some extent equal to 2D (Espinoza & Lee, 2004). Moreover, the level of exposure is reduced because the manipulations and reconstructions are performed after the patient leaves the ultrasound machine or offline.
Capabilities of 3D and 4D imaging ensures that fetal anatomy is seen clearly. Some of the features that can be seen easily are the arms, fingers, toes and face. This also allows detected of other features such as the cleft palate when compared to the capability of the 2D imaging (Mangione & Horovitz, 2003). Moreover, it allows fetus movement such as smiling, yawning, swallowing and moving of the fingers to be seen easily with the capability of the 4D sonography. It also allows the doctors to analyze small movements and health just like how pediatrician exams a newborn baby, but the doctors assess the fetus from head to the toe through the computer screen. Thus, 3D and 4D ultrasound technology plays an important role in ensuring that the status of the fetus is known in advance.
Three and four-dimensional (3D/4D) ultrasound plays an important part in the world of sonographic imaging in the gynecology and obstetrics. It is an important problem-solving tool when it is called upon. Its potential is huge and able to improve efficiency and patient throughput when properly utilized. The maturing technology in the field of sonography is important in advancing the health requirements of the parent and fetus.
This is exemplified by its ability in depicting the development of the fetus and predicting any anomalies that may occur. If used well it brings important bonding between the parents and other family related members. It plays an important role in pathogenesis allowing appropriate measures to be taken in advance. The equipment does not have ionizing effect or bio-effect that is associative with other equipments that are relevant in the given situation. However, the main requirement to achieve the benefits that are associated with 3D/4D in obstetrics and gynecology is if it is properly utilized.
References
Chaoui, R. & Heling, K. (2004). Three-dimensional (3D) and 4D color Doppler fetal echocardiography using spatio-temporal image correlation (STIC). Ultrasound Obstetrics Gynecology, 23, p. 535–545.
DeVore, G. & Platt, L. (2004). The “spin” technique: a new method for examination of the fetal outflow tracts using three-dimensional ultrasound. Ultrasound Obstetrics Gynecology, 24, p. 72–82.
Espinoza J. & Lee W. (2004). The use of the minimum projection mode in 4-dimensional examination of the fetal heart with spatiotemporal image correlation. Journal Ultrasound Medicine, 23, p. 1337–1348.
Gonçalves L. & Lee W. (2003). Four-dimensional ultrasonography of the fetal heart with spatiotemporal image correlation. American Journal Obstetrics Gynecology, 189, p. 1792–1802.
Jurgens J. & Chaoui R. (2003). Three-dimensional multiplanar time-motion ultrasound or anatomical M-mode of the fetal heart: a new technique in fetal echocardiography. Ultrasound Obstetrics Gynecology, 21, p. 119–123
Mangione R, & Horovitz J. (2003). Craniofacial dysmorphology and three-dimensional ultrasound: a prospective study on practicability for prenatal diagnosis. Prenatal Diagnosis, 23, p. 810–818.
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