A sonographic evaluation on agreement and time efficiency of fetal central nervous system biometry using semi-automated five-dimensional ultrasound versus standard two-dimensional ultrasound in a Philippine tertiary hospital

Abstract

BACKGROUND: Proper assessment and efficient diagnosis of central nervous system anomalies is essential in antenatal surveillance of pregnant patients. These anomalies are usually associated with genetic syndromes or severe malformations requiring timely intervention and antenatal counseling of the expectant couple. OBJECTIVE: The study aims to evaluate the agreement of cranial biometric measurements and to determine if there is a significant difference in the time needed to complete the evaluation using standard 2D and semi-automated 5D ultrasound. METHODS: An analytical cross-sectional study was employed on 93 women who underwent pelvic ultrasound scans from August to October 2022 in a tertiary hospital. Basic biometric fetal central nervous system (CNS) measurements were acquired using 2D ultrasound followed by 5D CNS ultrasound. Bland-Altman plots were used to evaluate the agreement of the measurements obtained. The difference in the time to completion was determined using independent t-test. RESULTS AND CONCLUSION: Our study found that 5D CNS ultrasound measurements showed 96.8% agreement with 2D ultrasound in 90 out of 93 fetuses. The 5D CNS ultrasound takes a shorter time of 90 seconds (s) to completion in comparison to 99 s using the 2D method (p=0.076). Upon stratification of the study population per trimester, in the second trimester, it took 76 s with 5D CNS vs 89 s with 2D, resulting to a statistically significant 13-second difference (p=0.044). In the third trimester, 5D CNS took 105 s vs 108 s with 2D (p=0.614). The time to completion of the scan using this technology is faster when used for second trimester pregnancies but could be affected by fetal-dependent and operator-dependent factors. Therefore, application of this new technology has the potential to improve workflow efficiency after the necessary training on 3D sonography and 5D CNS ultrasound software.