Two-dimensional (2D) ultrasound has been widely used in obstetrics in South Florida since the 1970s. Yet today, only a handful of hospitals have the equipment and expertise to offer 3D/4D scans, the latest generation of ultrasound technology.
One of those hospitals is Plantation General Hospital (PGH). Specializing in womens and childrens health, PGH proudly delivers close to 3,500 babies annually, and houses one of the busiest Level III neonatal intensive care units in Broward County. It also has a dedicated perinatal unit, where patients whose pregnancies are considered high-risk are closely monitored. These include, but are not limited to, women who are expecting multiple births, are over or under the normal maternal age, have certain genetic histories, or have chronic conditions, such as diabetes and high-blood pressure, that pose the potential for complications.
Members of the ultrasound team at Plantation General Hospital use state-of-the art equipment to perform 3D/4D scans. (l-r) Patrice Williams, Sandi Poker, Brenda Habib, Jill Pettit, and Lisa Kaplan.
At PGH, 3D/4D ultrasound is mainly reserved for these high-risk patients, says Michelle Marsh, MHSA, director of marketing and business development. While 3D/4D can provide a wonderful, prenatal bonding experience for parents-to-be, Plantation General uses it primarily for medical reasons. “Our focus is on clinical outcomes,” Marsh explains. “For us, 3D/4D is a valuable diagnostic tool that can help both physicians and parents alike.”
Ultrasound works by passing high-frequency sound waves through the body to produce pictures, or sonograms. In 2D ultrasound, the sound waves or echoes are reflected back in one direction, creating a flat image; in 3D, the echoes are sent back at different angles and processed by computer software, rendering an image with volume. 4D adds real-time movement, making a digital, moving image.
Sandi Poker, RDMS, RDCS, RVT, supervisor of ultrasound services at PGH, says that 3D/4D does not replace, but rather supplements, 2D procedures. All patients get a traditional (2D) ultrasound first, which shows the babys entire body; if a problem is spotted, the doctor then orders a 3D/4D scan to try and pinpoint the problem.
“3D/4D is not done routinely,” states Poker. “Its designed to zero in on something specific — something that the physician has already detected and wants to view more closely.”
By yielding a clearer, more volumetric image, 3D/4D can assist physicians in more accurately diagnosing certain anomalies. It can also help parents to better understand these anomalies and the options they present for their child. Studies show, for example, that 3D/4D is particularly effective in detecting facial clefts; skeletal malformations, such as spinal bifida; and abnormalities of the brain. Research is also being conducted on the role of 3D/4D ultrasound in diagnosing congenital heart disease and problems with the central nervous system.
Poker says that 3D/4-D scans, like 2D procedures, are painless, non-invasive, and safe for both mother and child. They can be performed at any stage of pregnancy, although 28-32 weeks is ideal. At that time, the baby has grown enough to provide a fairly defined image, but is not so developed that its crowded in the uterus, making it difficult to discern features.
Currently, the greatest use of 3D/4D ultrasound is in teaching hospitals and cardiac centers. Its less commonly found in general hospitals, at present, because the equipment is expensive. Another factor is that the procedure, which is time-intensive, requires the skill and knowledge of highly trained and registered technologists like Poker and her staff.
The fact that ultrasound technology continues to evolve is very exciting, says Poker. “There have been a lot of advancements over the past few years, especially in the area of equipment.” The machines, which are computer-based, are now smaller and even available in lap-top models. Additionally, the transducers, especially the latest 3D/4D probes, are lighter and easier to manipulate ”similar to artists paintbrush,” notes Poker. “As we tell our patients, doing an ultrasound today is like waving a wand that takes us on a truly magical journey through the womb.”
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