Second-trimester ultrasonography: Determinants of visualization of fetal anatomic structures

      This paper is only available as a PDF. To read, Please Download here.
      Little information has been published regarding rates of visualization of fetal anatomic structures or factors affecting visualization in unselected patients. We prospectively studied these points by scoring visualization of intracranial, spinal, cardiac, ventral wall, umbilical cord, stomach, bladder, and genital anatomy in 573 consecutive midtrimester scans in which no fetal anomalies were seen. Each feature was scored 0, 1, or 2, corresponding to poor, adequate, or optimal visualization, and these eight numbers were summed for an overall visualization score. Overall visualization fell abruptly beyond maternal weight 165 pounds
      (p < 0.001) and rose with advancing gestational age (p < 0.001). Placental location did not significantly influence visualization. Overall, an adequate screening scan, defined as adequate visualization of central nervous system, heart, stomach, ventral wall, bladder, and cord was obtained in 51% of scans, and optimal visualization of each of these in only 9% of cases. Factors that might improve anatomic visualization and the implications of these results for the use of ultrasonography in screening for congenital anomalies are discussed.

      Key words

      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'


      Subscribe to American Journal of Obstetrics & Gynecology
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect


        • American College of Obstetricians and Gynecologists
        Ultrasound in pregnancy. American College of Obstetricians and Gynecologists, Washington DCMay 1988 (ACOG Technical Bulletin 116)
        • Warsof SL
        • Cooper DJ
        • Little D
        • Campbell S
        Routine ultrasound screening for antenatal detection of intrauterine growth retardation.
        Obstet Gynecol. 1986; 66: 33-39
        • Green JJ
        • Hobbins JC
        Abdominal ultrasound examination of the first-trimester fetus.
        Am J Obstet Gynecol. 1988; 159: 165-175
        • Fleischer AC
        • Kirchner SG
        • Thieme GA
        Prenatal detection of fetal anomalies with sonography.
        Pediatr Clin North Am. 1985; 32: 1523-1536
        • Hegge FN
        • Prescott GH
        • Watson PT
        Sonography at the time of genetic amniocentesis to screen for fetal malformations.
        Obstet Gynecol. 1988; 71: 522-525
        • Pilu G
        • Romero R
        • Reece EA
        • Goldstein I
        • Hobbins JC
        • Bovicelli L
        Subnormal cerebellum in fetuses with spina bifida.
        Am J Obstet Gynecol. 1988; 158: 1052-1056
        • Copel JA
        • Pilu G
        • Green J
        • Hobbins JC
        • Kleinman CS
        Fetal echocardiographic screening for congenital heart disease: the importance of a four-chamber view.
        Am J Obstet Gynecol. 1987; 157: 648-655
        • Zador IW
        • Bottoms SF
        • Tse GM
        • Brindely BA
        • Sokol RJ
        Nomograms for ultrasound visualization of fetal organs.
        J Ultrasound Med. 1988; 7: 197-201
        • Perone N
        • Carpenter RJ
        • Robertson JA
        Legal liability in the use of ultrasound by office-based obstetricians.
        Am J Obstet Gynecol. 1984; 150: 801-804