Our findings suggest that 3-dimensional ultrasonographically derived measurements are reliable and reproducible up to 30 weeks if a standard measurement technique is used.

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The objectives of this study were to determine whether three-dimensional ultrasonography can provide more cardiac views than two-dimensional ultrasonography and to develop a standard technique. Eighteen women, 16 to 26 weeks' gestation, were scanned with twodimensional ultrasonography for 10 minutes or less to obtain fetal heart views. Threedimensional ultrasonography was used (≤10 minutes) to obtain up to 4 acquisitions of the fetal heart: 4-chamber view, left parasagittal, transverse, and longitudinal nonstandard. Views were later extracted from saved volume data, comparing the yields of two-and threedimensional ultrasonography. The 4-chamber view was obtained in 15 (93%) of 16 cases on both two-and three-dimensional ultrasonography. On two-dimensional ultrasonography, the left outflow tract was obtained in 68% of the cases; on three-dimensional ultrasonography, the left outflow tract was obtained in 46% from the 4-chamber view acquisition and in 100% from the left parasagittal acquisition. On two-dimensional ultrasonography, the right outflow tract was obtained in 68% of the cases; on three-dimensional ultrasonography, the right outflow tract was obtained in 86% from the 4-chamber view acquisition and in 71% from the left parasagittal acquisition. Aortic and ductal arches were obtained in 12% and 18%, respectively, on two-dimensional ultrasonography. On three-dimensional ultrasonography the aortic and ductal arches were obtained in 66% and 86%, respectively, from the 4-chamber view acquisition and in 57% and 71%, respectively, from the left parasagittal acquisition. Three-dimensional ultrasonography permitted a greater number of cardiac views to be extracted from volume data than did two-dimensional ultrasonography. Key words: three-dimensional ultrasonography; fetal heart screening; fetal echocardiography. Medicine, March 13-17, 1999, San Antonio, TX. Address correspondence and reprint requests to Gjergji Bega, MD, Department of Radiology, Division of Ultrasound, 132 S 10th St, Philadelphia, PA 19107. Abbreviations AA, aortic arch; DA, ductal arch; 4CHV, 4-chamber view; IVC, inferior vena cava; LVOT, left ventricle outflow tract; NSLV, nonstandard longitudinal view; NSTV, nonstandard transverse view; PAB, pulmonary artery and branches; RVOT, right ventricle outflow tract; SVC, superior vena cava; 3D, three-dimensional; 3DUS, threedimensional ultrasonography; 2D, two-dimensional; 2DUS, two-dimensional ultrasonography

3D US appears to offer a more complete assessment of the cervix than 2D US. Multiplanar correlation shows that the standard 2D US sagittal view may under- or over-estimate cervical length. Our preliminary data suggest that 3D US has the potential to improve our understanding of cervical morphology.

BackgroundIn 2006 WHO presented the infant and child growth charts suggested for universal application. However, major determinants for perinatal outcomes and postnatal growth are laid down during antenatal development. Accordingly, monitoring fetal growth in utero by ultrasonography is important both for clinical and scientific reasons. The currently used fetal growth references are derived mainly from North American and European population and may be inappropriate for international use, given possible variances in the growth rates of fetuses from different ethnic population groups. WHO has, therefore, made it a high priority to establish charts of optimal fetal growth that can be recommended worldwide.MethodsThis is a multi-national study for the development of fetal growth standards for international application by assessing fetal growth in populations of different ethnic and geographic backgrounds. The study will select pregnant women of high-middle socioeconomic status with no obvious environmental constraints on growth (adequate nutritional status, non-smoking), and normal pregnancy history with no complications likely to affect fetal growth. The study will be conducted in centres from ten developing and industrialized countries: Argentina, Brazil, Democratic Republic of Congo, Denmark, Egypt, France, Germany, India, Norway, and Thailand. At each centre, 140 pregnant women will be recruited between 8 + 0 and 12 + 6 weeks of gestation. Subsequently, visits for fetal biometry will be scheduled at 14, 18, 24, 28, 32, 36, and 40 weeks (+/− 1 week) to be performed by trained ultrasonographers.The main outcome of the proposed study will be the development of fetal growth standards (either global or population specific) for international applications.DiscussionThe data from this study will be incorporated into obstetric practice and national health policies at country level in coordination with the activities presently conducted by WHO to implement the use of the Child Growth Standards.