European Radiology

, Volume 17, Issue 2, pp 419–431 | Cite as

Evolution of fetal ultrasonography

  • F. E. AvniEmail author
  • T. Cos
  • M. Cassart
  • A. Massez
  • C. Donner
  • K. Ismaili
  • M. Hall


The authors wish to highlight the evolution that has occurred in fetal ultrasound in recent years. A first significant evolution lies in the increasing contribution of first trimester ultrasound for the detection of fetal anomalies. Malformations of several organs and systems have been diagnosed during the first trimester. Furthermore the systematic measurement of the fetal neck translucency has led to increasing rate of detection of aneuploidies and heart malformations. For several years now, three-dimensional (3D) and 4D ultrasound (US) have been used as a complementary tool to 2D US for the evaluation of fetal morphology. This brings an improved morphologic assessment of the fetus. Applications of the techniques are increasing, especially for the fetal face, heart and extremities. The third field where fetal US is continuously providing important information is the knowledge of the natural history of diseases. This has brought significant improvement in the postnatal management of several diseases, especially urinary tract dilatation and broncho-pulmonary malformation.


Fetus Ultrasound Abnormalities 


  1. 1.
    Lazanes E (2003) What’s new in first trimester US. Radiol Clin N Amer 41:663–679CrossRefGoogle Scholar
  2. 2.
    Souka AP, Nicolaides KH (1997) Diagnosis of fetal abnormalities at the 10–14 week scan. Ultrasound Obstet Gynecol 10:429–442PubMedCrossRefGoogle Scholar
  3. 3.
    Whitlow BJ, Chatzipapas IK, Lazanakis ML et al (1999) The value of sonography in early pregnancy for the detection of fetal abnormalities in an unselected population. Br J Obstet Gynaecol 106:929–936PubMedGoogle Scholar
  4. 4.
    Crane JP, LeFevre ML, Winborn RC et al (1994) A randomised trial of prenatal ultrasonographic screening impact on the detection, management, and outcome of anomalous fetuses. Am J Obstet Gynecol 171:392–399PubMedGoogle Scholar
  5. 5.
    Souka AP, von Kaisenberg CS, Hyetts JA, Sonek JD, Nicolaides KH (2005) Increased nuchal translucency with normal karyotype. Am J Obstet Gynecol 192:1005–1021PubMedCrossRefGoogle Scholar
  6. 6.
    Cicero S, Spencer K, Avigdou K, Faiola S, Nicolaides KH (2005) Maternal serum biochemistry at 11–13th weeks in relation to the presence or absence of fetal nasal bone on US in chromosomally abnormal fetuses. Prenatal Diagn 25:977–983CrossRefGoogle Scholar
  7. 7.
    Gyselaers WJA, Vereecken AJ, Van Herck EJH et al (2005) Population screening for fetal trisomy 21. Prenat Diagn 25:984–990PubMedCrossRefGoogle Scholar
  8. 8.
    Ganapathy R, Guven M, Sethna F et al (2004) Natural history and outcome of prenatally diagnosed cystic hygroma. Prenat Diagn 24:965–968PubMedCrossRefGoogle Scholar
  9. 9.
    Borell A (2004) The ductus venosus in early pregnancy and congenital anomalies. Prenat Diagn 24:688–692CrossRefGoogle Scholar
  10. 10.
    Kurjak A (1999) Are color and pulsed Doppler sonography safe in early pregnancy ? J Perinat Med 27:423–430PubMedCrossRefGoogle Scholar
  11. 11.
    Platt LD (2000) Three-dimensional ultrasound. Ultrasound Obstet Gynecol 16:295–298PubMedCrossRefGoogle Scholar
  12. 12.
    Campbell S (2002) 4D, or not 4D: that is the question. Ultrasound Obstet Gynecol 19:1–4PubMedCrossRefGoogle Scholar
  13. 13.
    Bega G, Lev-toaff A, Kuhlman K, Kurtz A, Goldberg B, Wapner R (2001) Three-dimensional ultrasonographic imaging in Obstetrics, present and future applications. J Ultrasound Med 20:391–408PubMedGoogle Scholar
  14. 14.
    Gerards FA, Engels MA, Twisk JW, van Vugt JM (2006) Normal fetal lung volume measured with three-dimensional ultrasound. Ultrasound Obstet Gynecol 27:134–144PubMedCrossRefGoogle Scholar
  15. 15.
    Vinals F, Mandujano L, Vargas G, Giuliano A (2005) Prenatal diagnosis of congenital heart disease using four-dimensional spatio-temporal image correlation (STIC) telemedicine via an Internet link: a pilot study. Ultrasound Obstet Gynecol 25:25–31PubMedCrossRefGoogle Scholar
  16. 16.
    Rotten D, Levaillant JM, Martinez H, Ducou le pointe H, Vicaut E (2002) The fetal mandible: a 2D and 3D sonographic approach to the diagnosis of retrognathia and micrognathia. Ultrasound Obstet Gynecol 19:122–130PubMedCrossRefGoogle Scholar
  17. 17.
    Pretorius DH, House M, Nelson TR, Hollenbach KA (1995) Evaluation of normal and abnormal lips in fetuses: comparison between three-and two-dimensional sonography. AJR Am J Roentgenol 165:1233–1237PubMedGoogle Scholar
  18. 18.
    Ulm MR, Kratochwil A, Lum B, Lee A, Berttelheim D, Bernaschek G (1999) Three-dimensional ultrasonographic imaging of fetal tooth buds for characterization of fetal clefts. Early Hum Dev 55:67–75PubMedCrossRefGoogle Scholar
  19. 19.
    Campbell S, Lees C, Moscoco G, Mall P (2005) US antenatal diagnosis of cleft palate by a new technique: the 3D “reverse face” view. Ultrasound Obstet Gynecol 25:12–18PubMedCrossRefGoogle Scholar
  20. 20.
    Johnson D, Pretorius D, Riccabona M, Budorick N, Nelson T (1997) Three-dimensional ultrasound of fetal spine. Obstet Gynecol 89:434–438PubMedCrossRefGoogle Scholar
  21. 21.
    Pretorius D, Nelson T (1994) Prenatal visualization of cranial sutures and fontanelles with three-dimensional ultrasonography. J Ultrasound Med 13:871–876PubMedGoogle Scholar
  22. 22.
    Chaoui R, Levaillant JM, Benoit B, Faro C, Wegrzyn P, Nicolaides KH (2005) Three-dimensional sonographic description of abnormal metopic suture in second- and third-trimester fetuses. Ultrasound Obstet Gynecol 26:761–764Google Scholar
  23. 23.
    Kos M, Hafner T, Funduk-Kurjak B, Bozek T, Kurjak A (2002) Limb deformities and three-dimensional ultrasound. J Perinat Med 30:40–47PubMedCrossRefGoogle Scholar
  24. 24.
    Monteagudo A, Timor Tritsch, Mayberry P (2000) Three-dimensional transvaginal neurosonography of fetal brain: “navigating” in the volume scan. Ultrasound Obstet Gynecol 16:307–311PubMedCrossRefGoogle Scholar
  25. 25.
    Bega G, Kuhlman K, Lev-Toaff A, Kurtz A, Wapner R (2001) Application of three-dimensional ultrasonography in the evaluation of the fetal heart. J Ultrasound Med 20:307–313PubMedGoogle Scholar
  26. 26.
    Nelson TR, Pretorius DH, Sklansky MS, Hangen-Ansert S (1996) Three-dimensional echocardiographic evaluation of fetal heart anatomy and function: acquisition, analysis and display. J Ultrasound Med 15:1–9PubMedGoogle Scholar
  27. 27.
    Ismaili K, Avni EF, Piepsz A, Wissing KM, Cochat P, Aubert D, Hall M (2004) Current management of infants with renal pelvis dilation: a survey by French speaking pediatric nephrologists and urologists. Pediatr Nephrol 19:966–971PubMedCrossRefGoogle Scholar
  28. 28.
    Gunn TR, Mora D, Pease P (1995) Antenatal diagnosis of urinary tract abnormalities by ultrasonography after 28 weeks gestation: incidence and outcome. Am J Obstet Gynecol 172:479–482PubMedCrossRefGoogle Scholar
  29. 29.
    Ismaili K, Hall M, Donner C, Thomas D, Vermeylen D, Avni FE (2003) Results of systematic screening for minor degrees of fetal renal pelvis dilatation in an unselected population. Am J Obstet Gynecol 188:242–246PubMedCrossRefGoogle Scholar
  30. 30.
    Stocks A, Richards D, Frentzen B, Richard G (1996) Correlation of prenatal renal pelvic anteroposterior diameter with outcome in infancy. J Urol 155:1060–1062CrossRefGoogle Scholar
  31. 31.
    Elder J (1992) Commentary: importance of antenatal diagnosis of vesicouretearal reflux. J Urol 148:1750–1754PubMedGoogle Scholar
  32. 32.
    Maizels M, Reisman ME, Flom LS, Nelson J, Fernbach S, Firlit CF, Conway JJ (1992) Grading nephro-ureteral dilatation detected in the first year of life: correlation with obstruction. J Urol 148:609–614PubMedGoogle Scholar
  33. 33.
    Chudleigh T (2001) Mild pyelectasis. Prenat Diagn 21:916–941CrossRefGoogle Scholar
  34. 34.
    Economou G, Egginton JA, Brookfield SK (1994) The importance of late pregnancy scans for renal tract abnormalities. Prenat Diagn 14:177–180PubMedCrossRefGoogle Scholar
  35. 35.
    Montemarano H, Bulas DI, Rushton G, Selby D (1998) Bladder distension and pyelectasis in the male fetus. J Ultrasound Med 17:743–749PubMedGoogle Scholar
  36. 36.
    Blachar A, Blachar Y, Livne PM, Zurkowski L, Pelet D, Mogilner B (1994) Clinical outcome and follow-up of prenatal hydronephrosis. Prenat Diagn 8:30–35Google Scholar
  37. 37.
    Avni FE, Garel L, Hall M, Rypens F (2002) Perinatal approach to anomalies of the urinary tract, adrenals and genital system. In: Avni EF (ed) Perinatal imaging. Springer, Berlin Heidelberg New York, pp 153–196Google Scholar
  38. 38.
    Yerkes EB, Adams MC, Pope JC, Brock JW (1999) Does every patient with prenatal hydronephrosis need voiding cystourethrography? J Urol 162:1218–1220PubMedCrossRefGoogle Scholar
  39. 39.
    Ismaili K, Avni FE, Hall M (2002) Results of systematic voiding cystourethrography in infants with antenatally diagnosed renal pelvis dilation. J Pediatr 141:21–24PubMedCrossRefGoogle Scholar
  40. 40.
    Ismaili K, Avni FE, Wissing M, Hall M (2004) Long-term clinical outcome of infants with mild and moderate pyelectasis: validation of neonatal ultrasound as a screening tool to detect significant nephro-uropathies. J Pediatr 144:759–765PubMedGoogle Scholar
  41. 41.
    John U, Kahler C, Schulz S, Mentzel HJ, Vogt S, Misselwitz (2004) The impact of fetal renal pelvic diameter on post natal outcome. Prenat Diagn 24:591–595PubMedCrossRefGoogle Scholar
  42. 42.
    Johnson AM, Hubbard AM (2004) Congenital abnormalies of the fetal/neonatal chest. Semin Roentgenol 39:197–214PubMedCrossRefGoogle Scholar
  43. 43.
    Levine D, Barnewolt CE, Mehta TS, Trop I, Estroff J, Wong G (2003) Fetal thoracic abnormalities: MR imaging. Radiology 228:379–388PubMedCrossRefGoogle Scholar
  44. 44.
    Langer B, Donato L, Riethmuller C, Becmeur F, Dreyfus M, Favre R, Schlaeder G (1995) Spontaneous regression of fetal pulmonary sequestration. Ultrasound Obstet Gynecol 6:33–39PubMedCrossRefGoogle Scholar
  45. 45.
    Hsu KF, Wu MH, Chang CH, Yao BL, Chang FM (1995) Complete intrauterine resolution of fetal congenital cystic adenomatoid malformation of the lung type III. J Ultrasound Med 14:871–875PubMedGoogle Scholar
  46. 46.
    Achiron R, Strauss S, Seidman DS, Lipitz S, Mashiach S, Goldman B (1995) Fetal lung hyperechogenicity: prenatal ultrasonographic diagnosis, natural history and neonatal outcome. Ultrasound Obstet Gynecol 6:40–42PubMedCrossRefGoogle Scholar
  47. 47.
    Thorpe-Beeston JG, Nicolaides KH (1994) Cystic adenomatoid malformation of the lung: prenatal diagnosis and outcome. Prenat Diagn 14:677–688PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag 2006

Authors and Affiliations

  • F. E. Avni
    • 1
    Email author
  • T. Cos
    • 2
  • M. Cassart
    • 1
  • A. Massez
    • 1
  • C. Donner
    • 2
  • K. Ismaili
    • 3
  • M. Hall
    • 3
  1. 1.Department of Medical ImagingErasme HospitalBrusselsBelgium
  2. 2.Department of Obstetrics and Gynecology, Fetal UnitErasme HospitalBrusselsBelgium
  3. 3.Department of Ambulatory Pediatric NephrologyErasme HospitalBrusselsBelgium

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