Comparison of three-dimensional, two-dimensional and color Doppler ultrasound in predicting the presence of a nuchal cord at birth.

Abstract

To compare the use of two-dimensional, color Doppler and three-dimensional ultrasound for predicting the presence of a nuchal cord at birth. Eighty-five singleton pregnancies without nuchal cord and 35 with nuchal cord (30 with a single coil of cord, four with a double coil, and one in which the cord was coiled around the neck three times) were studied within 1 week before delivery using transabdominal three-dimensional sonography. Two-dimensional and color Doppler ultrasound were also conducted for comparison. Two-dimensional, color Doppler and three-dimensional sonography identified in utero 24 (69%), 29 (83%) and 25 (71%), respectively, of the cases of nuchal cord found at birth. There were no significant differences in overall diagnostic indices of each diagnostic modality for detecting nuchal cord. However, the ability to view the nuchal cord (subjective assessment of the ease of visualization of nuchal cord) was better with three-dimensional sonography than with two-dimensional or color Doppler ultrasound. Three-dimensional surface imaging does not provide more useful diagnostic information compared with two-dimensional and color Doppler ultrasound for detecting nuchal cord in utero.