Document Detail


Feasibility of 3-dimensional sonographic examination of the fetal secondary palate during the second-trimester anatomy scan.
MedLine Citation:
PMID:  22123995     Owner:  NLM     Status:  In-Data-Review    
Abstract/OtherAbstract:
Objectives- To determine the feasibility of obtaining adequate 3-dimensional (3D) data sets to examine the fetal secondary palate during the second-trimester anatomy scan. Methods- During a 3-month period, 3D data sets of the fetal secondary palate were obtained from consecutive women undergoing routine second-trimester scans. Only structurally normal singleton fetuses with a normal upper lip on 2-dimensional (2D) sonography were included. Three-dimensional data sets were obtained using a mechanical transducer with a 45° sweep and the same settings as for the standard 2D scan, ideally when the fetus was facing the transducer, with mild extension of the head, and the ultrasound beams projecting caudally to cranially to avoid shadowing from the primary palate or mandible. No additional scanning time was allocated for examination of the palate. Acquired 3D data sets were analyzed offline using dedicated software, and the secondary palate was assessed using the "flipped face" technique. Results- Ninety-seven women met entry criteria and underwent second-trimester scans at a median gestational age of 22 completed weeks (range, 18-23 weeks). In 13 (13.4%) cases, it was not possible to obtain a midsagittal view of the face for capturing 3D volume data sets due to fetal position. Additional factors limiting visualization were shadowing from the primary palate in fetuses with flexion of the head in 30 (30.9%) cases, interposition of, or shadowing from, fetal arms or legs in 11 (11.3%), inability to reproduce a true midsagittal plane in 8 (8.2%), and poor image quality in 1 (1%). Therefore, it was only possible to assess the secondary palate in 34 (35.1%) cases. Conclusions- It is not feasible to obtain adequate 3D data sets for offline analysis of the fetal secondary palate in almost two-thirds of second-trimester fetuses during the routine scan. However, suboptimal visualization is primarily due to factors related to fetal position rather than equipment or image quality. This finding suggests that a dedicated scan, during which adequate time can be devoted to obtaining a satisfactory position in which the fetal face can be evaluated, may be warranted in high-risk cases.
Authors:
Waldo Sepulveda; Amy E Wong; Francella Castro; Begoña Adiego; Pilar Martinez-Ten
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Journal of ultrasound in medicine : official journal of the American Institute of Ultrasound in Medicine     Volume:  30     ISSN:  1550-9613     ISO Abbreviation:  J Ultrasound Med     Publication Date:  2011 Dec 
Date Detail:
Created Date:  2011-11-29     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8211547     Medline TA:  J Ultrasound Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1619-24     Citation Subset:  IM    
Affiliation:
Fetal Medicine Center, Casilla 208, Santiago 20, Chile. E-mail fetalmed@yahoo.com.
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