Abstract
Background: The fetal face reflects strictly the development of the fetal brain during its growth. Four-dimensional (4D) examination permits continuous monitoring of the examined parts of fetal face and surface. The final performance of obstetric sonographic images depends upon multiple factors, such as fetal lie, uterine wall, abdominal wall fat, amniotic fluid, and the number of gestations which may limit the optimum performance of (4D) ultrasound. The two-dimensional (2D) ultrasound is the first choice due to its wide availability, low cost, and real-time capabilities. The tangential view obtained by (2D) ultrasound coronal sections through the face showed the nose, nostril, lips, eye, lens, and hard palate.
Results: One hundred and sixty fetuses showed straight forwards obstetric examination by both 2D and 4D examinations with identical final reports. While the total number of fetuses with clear images by 2D frontal tangential coronal examination was 191 cases, only 29 cases failed, whereas 170 cases obtained clear images by 4D examination, and 50 cases failed. Both 2D and 4D ultrasound failed to obtain clear images of 19 cases, while 4D failed for 31 cases, and 2D failed for 10 cases. 2D imaging was found to be significantly better than 4D imaging, with a P value of 0.009.
Conclusion: 2D ultrasound using the frontal tangential coronal view is an essential part of the fetal examination and more superior than 4D ultrasound in assessing facial anatomy and anomalies, as well comparable to 4D ultrasound as regards fascial expression.