Current technology and rapidly evolving Three-dimensional (3D) and Four-dimensional (4D) ultrasound techniques with advanced High Definition live (HD live) application has made Fetal medicine accomplishable. The introduction of high-frequency probes and evolution from hand swept slice acquisition to mechanically oscillating to electronically oscillating transducers with complex post-processing algorithms has led to the visualization of 3D view or real-time 3D view (4D) of fetal structures. In this review, we present a rare antenatal case of duplication of the gall bladder, highlight the utility of 3D/4D imaging and HD live Silhouette aiding in better understanding anatomical relationships, diagnosis, and implication in counseling.

the diagnosis is simple and can be done with confidence as early as 10 weeks of pregnancy [7,8]. If only the apex of the heart is extra-thoracic and visibility is hampered by extruded abdominal material, cases of thoracoabdominal ectopia cordis may be difficult to diagnose. With the widespread use of first trimester sonography as a screening technique for aneuploidy in modern clinical practice, it is reasonable to assume that the majority of cases of ectopia cordis will be detected. This report aims to document one such case of ectopia cordis which was diagnosed as early as 7 weeks of gestation. Case ReviewA primigravida in her late 20s presented for a first-trimester examination for uncertain dates. A transvaginal examination using a GE VOLUSON S8 CORE sonographic system revealed a single live, 7 weeks, 3 days intrauterine gestation. An embryo was identified with the presence of cardiac activity. Transvaginal examination revealed the embryonic heart protruding outside the thorax. The diagnosis was reasonably obvious with still images as well (Fig. 1); videos delineated the abnormality in a dramatic fashion, making the diagnosis undeniable. The heart was seen extending well beyond the plane of the chest wall. The lady returned after 10 days with a spontaneous miscarriage at home. Products of conception were not available for further testing. DiscussionEctopia cordis is estimated to affect 0.7-0.8 out of every 100,000 deliveries [2]. Ectopia cordis is thought to be the result of a halt in the folding process of the heart which