You have been practising foetal imaging for a long time. Can you shed light on the advancements in this field and how obstetric ultrasound has been a key modality in enhancing prenatal screening?
I am amongst the first radiologists who introduced the modality of ultrasound imaging into the country. Over the last 34 years, I have witnessed the steady technical advances in ultrasound. The ultrasound image of the foetus over the years has incredibly improved. For example, we started out looking at a few landmarks in the midline of the brain and today we have exquisite images which enable us to see the surface folds of the brain, the optic chiasma and so on. The foetal heart can be studied in great detail regarding the chambers, vessels and their connections. The spinal cord in the vertebral column can be seen very well. The abdominal organs and limbs can be seen. In the first 10 weeks of pregnancy, we can now see the embryologic developmental milestones. With the introduction of Doppler scanning, we are able to map the blood flow in the heart and the blood vessels of the foetus. With 3D and 4D, we are now able to display the foetal interiors in three planes simultaneously. Surface rendering helps us to create pictures of the face limbs etc.
Regarding screening, we should include diagnosis. With years of research, we are now able to screen for chromosomal abnormalities in the foetus, preeclampsia in the mother, premature labour and so on. Screening means using ultrasound imaging for the entire pregnant population to pick up certain findings called markers. Presence of a marker increases the risk of the abnormality. On the other hand, diagnosis implies determining normality or abnormality in a particular foetus.
How has ultrasound helped in improving pregnancy outcomes in patients?
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