Three-Dimensional Ultrasonographic Assessment of the Umbilical Cordduring the 2nd and 3rd Tri mesters of Pregnancy

Abstract

Objective: To evaluate the umbilical cord and its abnormalities by use of three-dimensional ultrasonography with a specially developed abdominal three-dimensional transducer. Patients and Methods: Ninety-five pregnancies (92 normal, 2 with hydrops fetalis, and 1 with omphalocele) from 14 to 40 weeks of gestation were studied with a specially developed abdominal three-dimensional transducer (3.5 MHz). This system can provide conventional two-dimensional ultrasonography images and can also generate within seconds high-quality three-dimensional images in the surface and transparent mode with no need for an external workstation. A proportion of the umbilical cords (coiled or noncoiled free loop, abdominal insertion, and placental insertion) visualized at each gestational age interval is presented. Results: The proportion of the umbilical cords visualized during pregnancy except for between 24 and 27 weeks of gestation was about 70% (range 64–83%). Optimal visualization of the umbilical cord was achieved between 24 and 27 weeks of gestation. During this period it was possible to adequately depict the umbilical cord in 93% of the cases. The proportions of the noncoiled umbilical cord depicted during pregnancy ranged from 8 to 45%. The detection rate of abdominal insertion of the umbilical cord visualized at 14–19 weeks was 44%; the detection rate decreased thereafter. Placental insertion of the umbilical cord could not be identified after 28 weeks of gestation. In 2 cases with hydrops fetalis, edematous umbilical cord was evident. In 1 fetus, omphalocele was clearly depicted. Conclusions: The new three-dimensional ultrasound technology generates within seconds high-quality three-dimensional images of the umbilical cord, although limitation of viewing direction exists. These results suggest that the new three-dimensional ultrasonography has the potential to be a supplement to two-dimensional ultrasonography and might be useful in identifying abnormal umbilical cords in utero.

Three-Dimensional Ultrasonographic Visualization of Multiple Pregnancy

“…In the current study we used a specially developed abdominal 3-D transducer, and this imaging system proved capable of providing conventional 2-D ultrasonography images while also possessing the capacity to generate within seconds high-quality fine 3-D images on the screen with no need for an external workstation. Because the ultrasound beam is regarded as a projection ray in volume rendering, and ray tracing is conducted in real time, the pro-Hata/Aoki/Miyazaki/Iwanari/Sawada/ Tagashira cedure is not as complex, and images can be obtained immediately [13][14][15][16][17]. Moreover, the viewing angle is relatively wide (60°C).…”

HDlive for Assessment of Placenta and Umbilical Cord

“…31 Although, many umbilical cord abnormalities are detectable by conventional 2D sonography, [32][33][34][35] the demonstration of their entire view is impossible, especially in the third trimester of pregnancy. 1,4,6,9 Three-dimensional ultrasound allows visualization of umbilical cord abnormalities in all three dimensions at the same time, providing an improved overview and a more clearly defined demonstration of adjusted anatomical planes. 1,6,36,37 HDlive pictures of umbilical cord abnormalities are more readily discernible than those obtained by conventional 3D ultrasound.…”

“…1,4,6,9 Three-dimensional ultrasound allows visualization of umbilical cord abnormalities in all three dimensions at the same time, providing an improved overview and a more clearly defined demonstration of adjusted anatomical planes. 1,6,36,37 HDlive pictures of umbilical cord abnormalities are more readily discernible than those obtained by conventional 3D ultrasound.…”

“…[1][2][3][4][5][6][7][8][9] Three-dimensional ultrasound has the potential to provide improved visualization of the placental and umbilical cord anatomic morphology compared to twodimensional (2D) sonographic imaging. 10 HDlive, the latest ultrasound technology, facilitates the creation of clearer placental and umbilical cord images than those obtained using conventional 3D ultrasound owing to better depth perception and the depiction of skin-like colors, which gives the placental and umbilical cord images a more realistic appearance.…”

Three-dimensional Sonography in the Assessment of Normal Fetal Anatomy in Late Pregnancy

“…Three-dimensional ultrasound confirms suspected multicystic dysplastic kidney as well as renal agenesis and abnormal pelvic-ureteral junction. 53 Fetal intra-abdominal vessels are numerous and most of them can be visualized by color and power Doppler ultrasound. 54 The main veins of interest are the intrahepatic umbilical vein, the hepatic veins, the ductus venosus and the inferior vena cava.…”