4 D echogography and Fetal Morphology 4 D echogography and Fetal Morphology

Fetal morphology is performed by ultrasound and its purpose is to prove or reject the anatomical malformations of the fetus before its birth, thus achieving two targets: first: preventing the birth of handicapped children in the presence of malformations and second: saving to the mother the few months’ carriage of a fetus with malformations. In some countries of the European Community the fetal morphology is compulsory but in Bulgaria is still optional and with the consent of the parents.
When to perform fetal morphology?

The so-called early fetal morphology, which is performed between the 11th and 14th weeks of gestation when early signs of the structure abnormalities and Down syndrome could be detected. Next fetal morphology takes place between the 17th and 20th weeks of gestation when all organs, the skeleton and the systems of the fetus become visible. 
The fetal morphology between the 23rd and 25th weeks of gestation allows the screening of cardiac  abnormalities in fetal heart and large blood vessels . The performance of fetal morphology should be mandatory with high quality ultrasound apparatus, preferably 4D and performed by experienced operator. 

Furthermore, along with the fetal ultrasound morphology a biochemical screening is performed, which also could be preventive up to the14th weeks of gestation, when hCG (human Chorionic Gonadotropin) and PAPtestare performed and between the 15th and 17th weeks of gestation for prenatal Down syndrome testing.If it seems that chances are probable 1:250, it is appropriate to perform amniocentesis / sample of amniotic fluid under ultrasound control / thus to prove or deny by 100% the presence of chromosomal abnormalities. 
All the above said tests are performed in a walking case, i.e. the patient is not hospitalized, and the genetictests are proceeded in the national genetic laboratories of the country. 

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