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Three-dimensional Ultrasonographic Appearance of the Fetal Akinesia Deformation Sequence

Maternité, Hôpital Necker-Enfants Malades, Assistance Publique-Hôpitaux de Paris, Université de Paris V, Paris, France.

Address correspondence and reprint requests to Rodrigo Ruano, MD, Maternité, Hôpital Necker-Enfants Malades, 149 rue de Sèvres, 75743 Paris Cedex 15, France; e-mail: rodrigoruano{at}hotmail.com.

Objective. To present the appearance of the fetal akinesia deformation sequence by three-dimensional ultrasonography after four-dimensional ultrasonographic scanning. Methods. Three-dimensional surface-rendering images were used to show the fixed postural abnormalities of the fetal extremities and body. Four-dimensional ultrasonography was used to show that the postural abnormalities were fixed and to confirm the absence of fetal movements. These images were compared with the postmortem examination findings. Results. Three-dimensional ultrasonographic images of 3 cases of fetal akinesia deformation sequence are presented. Surface-rendering imaging and imaging in the skeletal mode were performed to show the postural abnormalities and the arthrogryposis. Conclusions. Facilitated by polyhydramnios, three- and four-dimensional ultrasonography provided clear images of the fixed postural abnormalities, which were confirmed by postmortem examination. Although prenatal diagnosis can be easily made by conventional ultrasonography, three-dimensional ultrasonography might be used as a confirmatory approach. In addition, the quality of recent three-dimensional imaging might help prenatal counseling by providing images more readily understandable to the parents than those obtained by two-dimensional ultrasonography.

Key Words: contractures • fetal akinesia deformation sequence • fetal movements • postural deformities • prenatal diagnosis • three-dimensional ultrasonography • ultrasonography

Abbreviations: 4DUS, four-dimensional ultrasonography • 3DUS, three-dimensional ultrasonography • 2DUS, two-dimensional ultrasonography

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