P09.20: Some answers to 4D prenatal bonding

To compare maternal and physician attitudes towards three- and four-dimensional ultrasound (3/4DUS). An overall of 1000 routine prenatal scans were included, randomized selected, considering any gestational age or indication for referral. Scans were performed in our private Unit between August 2005 and March 2006, with Voluson 730 Expert (GE Medical System), by nine experts in 2DUS. After a 2D detailed examination of the fetal anatomy, 3/4DUS was obtained in all cases. Examination time was approximately 30 min for both 2D and 3DUS. Patients were given a medical report, copies of the 3D images obtained, and a video-tape to take home with examination recorded. Data were collected from a questionnaire immediately after the sonographic examination, addressed to the pregnant women, the physician performing the scan, and an independent observer. Considering quality of images, there is no agreement between the assessment of 3/4D images by pregnant women and physician (48% of discordance, Kappa concordance index = 0.006) nor with the independent observer (42% of discordance, Kappa concordance index = 0.14). A total of 33% of patients are very satisfied despite of the low quality images assessed by the physician. There is agreement between the assessment of 3/4D images by the physician and the independent observer (74% of concordance, p = 0.000, Kappa concordance index = 0.5). There is agreement between the maternal satisfaction and the one perceived by the sonographer (85% of concordance, p = 0.000, Kappa index = 0.05). There is no agreement between the objective assessment of 3D images and the maternal satisfaction level, probably due to the additional value of 4D and the different maternal expectations facing the 3/4D examination.