First-Trimester Ultrasound Volumetry

Measurement Techniques and Potential Application in the Prediction of Pregnancy Complications

Kwok Yin Leung; Teresa Ma; Betty YT Lau; Min Chen

Disclosures

Expert Rev of Obstet Gynecol. 2012;7(4):379-386. 

In This Article

Five-Year View

The possible applications of 3D volumetry in the first trimester include prediction of IUGR, PE, birthweight, homozygous α0-thalassemia and other adverse pregnancy outcomes. With advances in technology, 3D volumetry will be much simpler and more accurate, and the measurement time will be reduced.

Standardization of 3D volumetric methodology and training might improve the quality assurance in first-trimester volumetry, and then facilitate clinical use.[54] Further development of 3D technology may allow a semiautomated or automated measurement of 3D volumetry in a reliable and accurate manner.

In the future, the prediction of IUGR and PE could be improved, and ideally be incorporated in the same setting as first-trimester screening for Down's syndrome. Combining first-trimester volumetry with other methods including maternal history, 2D sonographic parameters such as uterine artery Doppler and biochemical markers such as placental hormones is promising.[31] With the recent advances in 3D power Doppler ultrasound and histogram analysis, it is feasible to perform assessments of the vascularization and blood flow of the placenta,[64] with good reproducibility of the 3D power Doppler parameters.[65] Altered 3D fetoplacental volumetry and placental Doppler indices are related to subsequent development of IUGR, PE and other adverse pregnancy outcomes.[64,66] Further studies are required to determine the choice of parameters to achieve the best predictive models.

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