Donald School Journal of Ultrasound in Obstetrics and Gynecology

Register      Login

VOLUME 17 , ISSUE 4 ( October-December, 2023 ) > List of Articles

Original Article

34 Years of Clinical 3D Ultrasound: A Major Step in Prenatal Diagnosis

Eberhard Merz, Sonila Pashaj

Keywords : History, Prenatal diagnosis, Three-dimensional ultrasound

Citation Information : Merz E, Pashaj S. 34 Years of Clinical 3D Ultrasound: A Major Step in Prenatal Diagnosis. Donald School J Ultrasound Obstet Gynecol 2023; 17 (4):341-348.

DOI: 10.5005/jp-journals-10009-1996

License: CC BY-NC 4.0

Published Online: 28-12-2023

Copyright Statement:  Copyright © 2023; The Author(s).


Within the last 34 years, three-dimensional (3D) sonography has undergone enormous development in prenatal diagnostics. On the one hand, this concerns transducer technology, and on the other hand, optimization in ultrasound device ergonomics. Advances in computer technology have also made it possible to accelerate the computational steps required for 3D sonography in ultrasound devices. The different 3D display modes that are available today offer enormous additional potential in prenatal diagnostics, especially for the examiner experienced in two-dimensional (2D) sonography. In this way, 2D planes can be controlled in a targeted manner, and unclear or complex structures, as well as axis deviations, can be spatially displayed. Fetal malformations can thus be precisely depicted from different angles or specifically excluded. In particular, surface defects can thus be clearly demonstrated to the parents-to-be. The aim of this publication is to provide an overview of the development and potential of 3D ultrasound technology in prenatal diagnostics.

  1. Szilard J. An improved three-dimensional display system. Ultrasonics 1974;12(6):273–276. DOI: 10.1016/0041-624X(74)90137-1
  2. Kirbach D, Whittingham TA. 3D ultrasound - the Kretztechnik Voluson® approach. Eur J Ultrasound 1994;1:85–89.
  3. Gritzky A, Brandl H. 3-D Ultrasound in Obstetrics and Gynecology. Lippincott Williams & Wilkins; 1998. pp. 9–15.
  4. Merz E, Evans DH, Dong Y, et al. History of ultrasound in obstetrics and gynaecology from 1971 to 2021 on occasion of the 50 years anniversary of EFSUMB. Med Ultrason 2023;25(2):175–188. DOI: 10.11152/mu-3845
  5. Merz E. 25 years of 3D ultrasound in prenatal diagnosis (1989-2014). Ultraschall Med 2015;36(1):3–8. DOI: 10.1055/s-0034-1398866
  6. Merz E. Ultrasound in Obstetrics and Gynecology. Thieme Stuttgart; 2005. pp. 516–528.
  7. Merz E, Pashaj S. Advantages of 3D ultrasound in the assessment of fetal abnormalities. J Perinat Med 2017;45(6):643–650. DOI: 10.1515/jpm-2016-0379
  8. Merz E. Current 3D/4D ultrasound technology in prenatal diagnosis. Eur Clinics Obstet Gynaecol 2005;1(3):184–193. DOI: 10.1007/s11296-005-0005-6
  9. Merz E, Pashaj S. Current Progress in Obstetrics and Gynaecology. 2015. pp. 282–302.
  10. Merz E, Abramowicz JS. 3D/4D ultrasound in prenatal diagnosis: is it time for routine use? Clin Obstet Gynecol 2012;55(1):336–351. DOI: 10.1097/GRF.0b013e3182446ef7
  11. Merz E, Abramovicz J, Baba K, et al. 3D imaging of the fetal face - recommendations from the International 3D Focus Group. Ultraschall Med 2012;33(2):175–182. DOI: 10.1055/s-0031-1299378
  12. De Jong-Pleij EA, Ribbert LS, Tromp E, et al. Three-dimensional multiplanar ultrasound is a valuable tool in the study of the fetal profile in the second trimester of pregnancy. Ultrasound Obstet Gynecol 2010;35(2):195–200. DOI: 10.1002/uog.7471
  13. Tutschek B, Blaas HK, Abramowicz J, et al. Three-dimensional ultrasound imaging of the fetal skull and face. Ultrasound Obstet Gynecol 2017;50(1):7–16. DOI: 10.1002/uog.17436
  14. Benoit B, Chaoui R. Three-dimensional ultrasound with maximal mode rendering: a novel technique for the diagnosis of bilateral or unilateral absence or hypoplasia of nasal bones in second-trimester screening for Down syndrome. Ultrasound Obstet Gynecol 2005;25(1):19–24. DOI: 10.1002/uog.1805
  15. Faro C, Chaoui R, Wegrzyn P, et al. Metopic suture in fetuses with Apert syndrome at 22-27 weeks of gestation. Ultrasound Obstet Gynecol 2006;27(1):28–33. DOI: 10.1002/uog.2648
  16. Pashaj S, Merz E, Wellek S. Biometry of the fetal corpus callosum by three-dimensional ultrasound. Ultrasound Obstet Gynecol 2013;42(6):691–698. DOI: 10.1002/uog.12501
  17. Pashaj S, Merz E. 3-Dimensional ultrasound: how can the fetal corpus callosum be demonstrated correctly? Ultraschall Med 2021;42(3):278–284. DOI: 10.1055/a-1365-8611
  18. Merz E, Pashaj S, Wellek S. Normal fetal growth profile at 10-41 weeks of gestation - an update based on 10225 normal singleton pregnancies and measurement of the fetal parameters using 3D ultrasound. Ultraschall Med 2023;44(2):179–187. DOI: 10.1055/a-1968-0018
  19. Tonni G, Grisolia G, Bonasoni MP, et al. Fetal hands: a comprehensive review of prenatal assessment and diagnosis over the past 40 years. Ultrasound Med Biol 2023;49(3): 657–676. DOI: 10.1016/j.ultrasmedbio.2022.09.022
  20. DeVore GR, Falkensammer P, Sklansky MS, et al. Spatio-temporal image correlation (STIC): new technology for evaluation of the fetal heart. Ultrasound Obstet Gynecol 2003;22(4):380–387. DOI: 10.1002/uog.217
  21. Chaoui R, Hoffmann J, Heling KS. Three-dimensional (3D) and 4D color Doppler fetal echocardiography using spatio-temporal image correlation (STIC). Ultrasound Obstet Gynecol 2004;23(6):535–545. DOI: 10.1002/uog.1075
  22. Adriaanse BM, van Vugt JM, Haak MC. Three- and four-dimensional ultrasound in fetal echocardiography: an up-to-date overview. J Perinatol 2016;36(9):685–693. DOI: 10.1038/jp.2016.23
  23. Karmegaraj B, Kumar S, Srimurugan B, et al. 3D/4D spatiotemporal image correlation (STIC) fetal echocardiography provides incremental benefit over 2D fetal echocardiography in predicting postnatal surgical approach in double-outlet right ventricle. Ultrasound Obstet Gynecol 2021;57(3):423–430. DOI: 10.1002/uog.21988
  24. DeVore GR, Satou G, Sklansky M. 4D fetal echocardiography—an update. Echocardiography 2017;34:1788–1798.
  25. Chaoui R, Abuhamad A, Martins J, et al. Recent development in three and four dimension fetal echocardiography. Fetal Diagn Ther 2020;47(5):345–353. DOI: 10.1159/000500454
  26. Kurjak A, Miskovic B, Stanojevic M, et al. New scoring system for fetal neurobehavior assessed by three- and four-dimensional sonography. J Perinat Med 2008;36(1):73–81. DOI: 10.1515/JPM.2008.007
  27. Kurjak A, Antsaklis P, Stanojevic M, et al. Multicentric studies of the fetal neurobehavior by KANET test. J Perinat Med 2017;45(6):717–727. DOI: 10.1515/jpm-2016-0409
  28. Benoit B, Hafner T, Kurjak A, et al. Three-dimensional sonoembryology. J Perinat Med 2002;30(1):63–73. DOI: 10.1515/JPM.2002.009
  29. Merz E, Welter C. 2D and 3D Ultrasound in the evaluation of normal and abnormal fetal anatomy in the second and third trimesters in a level III center. Ultraschall Med 2005;26(1):9–16. DOI: 10.1055/s-2004-813947
  30. Schramm T, Gloning KP, Minderer S, et al. 3D ultrasound in fetal spina bifida. Ultraschall Med 2008;29(Suppl 5):289–290. DOI: 10.1055/s-2008-1027911
  31. Pooh RK, Kurjak A. 3D/4D sonography moved prenatal diagnosis of fetal anomalies from the second to the first trimester of pregnancy. J Matern Fetal Neonatal Med 2012;25(5):433–455. DOI: 10.3109/14767058.2011.636107
  32. Ji C, Yang Z, Yin L, et al. The application of three-dimensional ultrasound with reformatting technique in the diagnosis of fetal cleft lip/palate. J Clin Ultrasound 2021;49(4):307–314. DOI: 10.1002/jcu.22994
  33. Merz E, Pashaj S. Three-dimensional/four-dimensional ultrasound: the key for the precise assessment of fetal malformations. Donald School J Ultrasound Obstet Gynecol 2023;17(2):158–164. DOI: 10.5005/jp-journals-10009-1971
  34. Barišić LS, Stanojević M, Kurjak A, et al. Diagnosis of fetal syndromes by three- and four-dimensional ultrasound: is there any improvement? J Perinat Med 2017;45(6):651–665. DOI: 10.1515/jpm-2016-0416
  35. Hallgrímsson B, Aponte JD, Katz DC, et al. Automated syndrome diagnosis by three-dimensional facial imaging. Genet Med 2020;22(10):1682–1693. DOI: 10.1038/s41436-020-0845-y
  36. Merz E, Kurjak A. 1989–2019: 30 years of 3D ultrasound in obstetrics and gynecology. Donald School J Ultrasound Obstet Gynecol 2018;12(2):94–98. DOI: 10.5005/jp-journals-10009-1557
  37. Merz E, Chaoui R. 30-year anniversary of ultrasound: Clinical use of 3D ultrasound in obstetrics and gynecology (1989-2019). Ultraschall Med 2019;40(3):288–291. DOI: 10.1055/a-0868-3760
  38. Meng L, Zhao D, Yang Z, et al. Automatic display of fetal brain planes and automatic measurements of fetal brain parameters by transabdominal three-dimensional ultrasound. J Clin Ultrasound 2020;48(2):82–88. DOI: 10.1002/jcu.22762
  39. Pluym ID, Afshar Y, Holliman K, et al. Accuracy of automated three-dimensional ultrasound imaging technique for fetal head biometry. Ultrasound Obstet Gynecol 2021;57(5): 798–803. DOI: 10.1002/uog.22171
PDF Share
PDF Share

© Jaypee Brothers Medical Publishers (P) LTD.