Application of 3D and 4D ultrasound for Evaluation Abnormal Pregnancy

The first trimester is characterized by many important landmarks with regard to ultimate outcome of pregnancy and is mostly defined by the first 100 days pregnancy. Women becomes aware of her pregnancy after missing her last period and in that time she is already at least weeks pregnant. A positive pregnancy test opens Pandoras box offering more questions than answers. Ultrasound evaluation of an early pregnancy includes detection of the pregnancy location (extra uterine or intrauterine, the type of pregnancy, one fetus or multiple pregnancy, molar pregnancy), the viability of the pregnancy and establishment of gestational age. Evaluating pregnancy, the ultrasonographer also recognizes the complications that may occur in first trimester. Ultrasound examination has become the golden standard in follow up the development and complications of early pregnancy. With introduction of transvaginal sonography (TVS), a possibility for early morphological and biometrical ultrasound examinations has been significantly improved. Application of color Doppler ultrasound has enabled functional hemodynamic presentation and evaluation soon after implantation .basic ultrasound markers for normal pregnancy are intrauterine gestational sac, morphologically, normal embryo and its heart action. Normal embryonic echo in 90% of the cases suggest normal pregnancy. Application of 3D and 4D ultrasound seems to be advantageous in determining the point for differentiation of the embryo and the fetus.

Early Pregnancy Failure
Early Pregnancy Failure is defined as a pregnancy that ends spontaneously before the embryo is detected by ultrasound at the gestational age in which visualization of viable embryo should occur . the most common pathogical symptom of the early pregnancy failure is the vaginal bleeding.

One of main problems in diagnosis of early pregnancy failure is why vaginal bleeding occurs. When it happened, all clinicians should answer several questions that can radically alter the management :

• Is the patient pregnant?
• Is the embryo viable or not?
• What is gestational age?
• Is there any evidence to suggest that the pregnancy is ectopic?
• If an abortion occurs, is it complete or incomplete?

Is there any associated pelvic mass?Only differentiation and accurate estimation of the pregnancy status and embryo/fetus status make it possible to obtain appropriate therapeutic measures to cases where a normal outcome of the pregnancy can be expected. At this moment, ultrasonography is considered to be the best diagnostic method for detection of early pregnancy complications. For these patients the skill of the ultrasonographer is very important, since the accurate diagnosis of pregnancy failure will often result in surgical intervention. clinical presentation of the symptom such as vaginal bleeding and abdominal paint, with or without the expulsion of the product of conception is suspected of a spontaneous abortion. For ultrasound evaluation, it is important to distinguish threatened, complete and incomplete abortion