Should 3D be part of a routine obgyn ultrasound exam?

Abstract

Ultrasound (US) is, arguably, the most commonly used diagnostic technology in obstetrics and gynecology. Several applications are commonly employed in daily practice, such as M-mode, color and spectral Doppler. A more recent development is three-dimensional (3D) US. This is considered a very good (but complementary) tool to evaluate the face, brain, palate, spine, skeleton and heart, among others. Artificial intelligence software may allow automatic extraction of various parameters, including, for instance, semi-automated detection of specific facial features in syndromes associated with dysmorphism. All of the above, however, is relevant in the hands of the ultrasound specialist, performing advanced studies (so-called “level II”) and not in the routine obstetric practice The situation is slightly different in gynecology. While advanced practitioners may create mapping of the pelvic floor or myoma localization, or verify location of masses with 3D US, a routine pelvic ultrasound is not complete, nowadays, without a coronal view of the uterus. This view is rarely, if ever, possible with 2D ultrasound, but is easily obtainable with a quick sweep and 3D reconstruction. It allows for clearly depiction of the endometrial cavity, in cases of suspected Mullerian anomalies or “lost” string to verify the position of the IUD.