Background: Central nervous system (CNS) malformations are the most common congenital abnormalities. The detection of fetal anomalies was one of the earliest uses and remains a pivotal application of prenatal ultrasound. Objective: This prospective study aims to clear out the value of 3/4D examination with advanced techniques (TUI, MIP & surface mode) over 2D in the evolution of fetal neural anomalies. Patients and methods: 120 pregnant women with suspected CNS fetal anomalies by 2D US were examined over a period starting from January 2015 until October 2017. Fetal gestation ranged from 8-39 weeks with a 24-week mean age. In all patients, 2D and 3/4D ultrasound as well as fetal Doppler were performed. Results: 3/4D ultrasound shows higher sensitivity in the detection of neural anomalies such as anencephaly, Chiari malformation, Hydranencephaly, holoprosencephaly, encephalocele, meningocele (spina bifida with no brain changes), Iniencephaly and Dandy-Walker variants, 3/4D ultrasound of 100% deletion rate over 85% for the 2D ultrasound. 3/4d & 2D ultrasound had the same detection rate of anomalies like hydrocephalus (communicating & non-communicating), microcephaly, and Dandy-Walker malformation. Conclusion: 3/4D ultrasound had a higher sensitivity in the detection of fetal neural anomalies over 2D which allows early interference or decision-making to save fetal or material life.
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