The aim of this review is to evaluate the use of these advanced technologies in obstetrics. Over the years, there have been several improvements in ultrasound technologies including high-resolution ultrasonography, linear transducer, radiant flow, three/four-dimensional (3D/4D) ultrasound, speckle tracking of the fetal heart, and artificial intelligence. In the midst of such increasing standards of obstetric ultrasound examination, there is a demand on improving the diagnostic capability, functional analysis, workflow, and ergonomics. Although a detailed diagnostic scan is not required for all pregnant women, the indications include family history of congenital malformation, maternal age 35 or above, gestational diabetes mellitus, artificial reproduction technology, body mass index >= 30, teratogen, fetal nuchal translucency >= 3mm, and many other conditions. A high-resolution ultrasound can facilitate a detailed diagnostic scan and a first-trimester scan and allow the detection of a small or subtle abnormality. The detection rate of fetal abnormalities varies, depending on anatomy survey protocol, ultrasound equipment and setting, among other factors. In addition, a recent study showed that a routine scan at around 36 weeks’ gestation can detect around 0.5% of previously undetected fetal abnormalities, as well as fetal growth restriction (FGR). Around 50% of major structural abnormalities can be detected in the first trimester. Although the introduction of prenatal cell-free DNA-based screening for Down syndrome has changed the role of the first trimester scan, the latter should still be offered to women. ISUOG has published recent guidelines on indications and practice of targeted neurosonography.
Recently, The American Institute of Ultrasound in Medicine (AIUM) suggests a detailed diagnostic second/third trimester scan for high-risk pregnancies, and fetal echocardiography for at-risk pregnancies. In 2010, International Societies of Ultrasound in Obstetrics and Gynecology (ISUOG) published the practice guidelines on the minimal and optional requirements for a routine mid-trimester ultrasound scan. Ultrasound is widely used in obstetric practice to detect fetal abnormalities with a view to provide prenatal opportunities for further investigations including genetic testing and discussion of management options.
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