3-D scans may help change behaviors, attitudes. (Offer Reassurance, Pinpoint Anomalies).

SACRAMENTO - With 3-D ultrasound becoming more routine, physicians have to be aware of the profound impact these scans can have on expectant parents.

The 2-D scans do not compare, Dr. Dolores H Pretorius said at an ultrasound update sponsored by the University of California, Davis.

Three-dimensional ultrasound images can stir deep emotion and change the perception of a pregnancy dramatically. They can change decisions about termination and can probably even affect health behaviors, she said.

Many ultrasound scans are basically done for reassurance, said Dr. Pretorius, a professor of radiology at the University of California, San Diego. But since anxiety can affect health and recovery; reassurance should be viewed as more than a luxury. In that respect, 3-D pictures can be more meaningful because they are images that patients can understand.

The most important diagnostic use of 3-D ultrasound is in evaluating cleft lip and cleft palate. In some cases, it can actually rule out a deft palate when there is a shadow on standard 2-D ultrasound, which is a tremendous relief for parents, she said. In other cases it can more precisely define the extent of the anomaly which prepares them for how the child will look after birth. Some patients she has had have changed their decision about termination following a 3-D scan. While nothing can soften the blow of a nonreassuring scan, 3-D scans can be beneficial even in some of these cases, she said.

In her experience, the patients for whom 3-D ultrasound appears to be most beneficial are those with a personal or family history of prior anomalies or fetal demise, infertiity patients, surrogate parents, and, perhaps surprisingly, patients carrying fetuses with fatal anomalies.

One patient who had 3-D ultrasound of ...