For – 3D ultrasound in first and second trimester – hype or helpful?

Brief history 3D ultrasound has been the most rapidly evolving technique and technology in fetal ultrasound in the past few years. The technology began with “hand swept” slice acquisition using standard transducers followed by mechanically oscillating 3D transducers. This lead to 4D (real-time 3D), and now the development of solid-state electronically oscillating transducers. Accompanying the hardware has been a similar explosion in software programming allowing complex manipulation and storage of the data. In fact, it is fair to say that at this time, the technology advances have been so profound that they have left the technique of most of us (human sonologists) way behind. My experience initially with manually swept 3D was that my personal enthusiasm did not translate widely to either my colleagues or to the public. However, with the advent of high quality real-time 4D scanners, which are easy to use and have a high rate of successful imaging, there is a sustained enthusiasm of use with colleagues and patients. This enthusiasm for 4D scanning should have the effect of improving our (operator) technique, and will also encourage the development of how we use 4D. Already, there is a proliferation of papers outlining the uses, a lot may stay as research or of academic interest only (hype), but some will translate to real advances in everyday practical fetal ultrasound (helpful). I will outline some of the areas where I have found 3D helpful in my scanning (private practice).