A comparison of first trimester 3D multiplanar sonography in the obese and non-obese population
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- Restricted to UC San Diego use only
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- 2011
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1 online resource (16] p.)
- Note
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Forms part of the UCSD School of Medicine independent study projects, Class of 2011
Includes bibliographical references (p. [16])
Objectives : Maternal obesity is known to affect visualization of fetal anatomy during the routine first and second trimester 2D sonogram. Approximately half of all fetal structures are not seen during routine ultrasound in women with a BMI >30 kg/m2. The aim of this study was to determine whether the addition of multiplanar 3D transvaginal ultrasound in the first trimester would increase the likelihood of obtaining a complete fetal anatomic survey. We hypothesized that addition of 3D multiplanar transvaginal views would increase the anatomic structure visualization rate by 20%. Methods : A prospective cohort study was undertaken of women presenting for their nuchal translucency evaluation in the first trimester. All enrollees were between the gestational ages of 11w1d to 14w0d. Maternal BMI at the time of ultrasound was collected. The patients were divided into obese and non-obese groups. A BMI of ≥30 kg/ m2 was used to stratify patients in either group. Patients underwent a routine first trimester 2D transabdominal biometry and anatomic survey, which included 20 discrete anatomic structures. At least one 3D multiplanar volume was then obtained transvaginally. One investigator reviewed the stored images and volumes offline following a standardized protocol. Results : A total of 43 patients with singleton fetuses were examined. 16 patients were found to have a BMI ≥30 kg/m2 and 28 controls had a BMI < 30 kg/m2. Data was collected for both 2D and 3D components of the evaluation and expressed as a percentage of total structures evaluated. The most common structures not visualized in either group were 4-chamber heart view (21), posterior fossa (17), and kidneys (15). Overall, the anatomic structure visualization rate in the first trimester was 80% for 2D+3D compared to 60% for 2D alone (p<0.001). Visualization of structures in the obese cohort was consistently lower than in the non-obese. Visualization rates for 2D+3D in the obese was 65% compared to 85% in those who were non-obese (p< .001). In the obese cohort, addition of 3D volumes increased visualization from 45% to 65% (p=0.001). Conclusion : The addition of 3D transvaginal ultrasound significantly improved the percentage of anatomic structures visualized in the first trimester. However, visualization of fetal structures in the obese population remained significantly lower, despite addition of this technique. A complete basic anatomic survey was not achieved in any of our cases
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Mms: 991004971209706535
- Thesis
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Thesis (M.D.)--University of California, San Diego, 2011
- Rights Holder
- R Mervis
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Under copyright (US)
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Academic Liaison Program, University of California, San Diego, La Jolla, 92093-0175 (http://ucsd.libguides.com/c.php?g=91092&p=584168)
- Last Modified
2024-07-19