Technology that brings an expecting mother the thrill of seeing a more lifelike image of the baby inside her womb also makes it possible for doctors to more accurately assess birth defects before the baby is born.

The Perinatal Center of Iowa, which is operated by Mercy Medical Center – Des Moines, is one of a growing number of obstetrics offices around the country that has invested in ultrasound machines that produce three-dimensional images. Since the center added three 3-D machines about a year and a half ago, the technology has dramatically changed the ultrasound experience for patients and staff.

“Life is in 3-D, so it’s very difficult for a patient with an untrained eye to see in 2-D,” said Emily Chambers, PCI’s lead sonographer. “The 3-D capability is a very useful tool for the parents and us to get a better idea of what the baby is going to look like on the outside.”

The Perinatal Center specializes in caring for expecting mothers who have medical complications with their pregnancies, and it also operates a busy ultrasound practice, said Neil Mandsager, a perinatologist at PCI. The center performs obstetrics ultrasounds for other physicians’ patients on a referral basis. The referral patients are not necessarily women with high-risk pregnancies.

Mandsager said the technology for 3-D ultrasound images – called 4-D when performed in real time – allows a patient to see a realistic image of her developing fetus.

“The technology has been gradually improving specific to 3-D over the past five years,” Mandsager said. “We were looking at it three or four years ago, but felt like it was rather clumsy at the time. There was a fairly dramatic improvement over the last few years that now allows you to do a 3-D image almost as quickly as the 2-D image.”

The 3-D images have been particularly beneficial for many cases with fetal abnormalities such as cleft lip and spina bifida.

“The 3-D has helped us image neural tube defects or spina bifida,” Mandsager said. “We’re finding that the 3-D imaging helps us localize where the defect is better than the 2-D can alone.”

The technology also helps doctors and patients visualize what the defect will look like when the baby is born.

“We’ve found that the 3-D images are quite helpful in showing parents exactly what the defect is and what it looks like,” Mandsager said. “Oftentimes, it’s reassuring to them. When they hear that something is wrong, they might have the worst image in their head. But we’ve found that the 3-D imaging demonstrates to the mom that it’s not as bad as they thought.”

Bethany Walbaum found out during a routine ultrasound at her Ames doctor’s office that her baby had some abnormal swelling in its head. She was sent to PCI for further evaluation and had her first 3-D ultrasound at 22 weeks, where it was confirmed that her baby has spina bifida, a neural tube defect involving imperfect closure to the spinal column.

Walbaum, who was due to deliver her baby March 10, had a total of four 3-D ultrasounds during her pregnancy. The experience helped educate her and her husband about her daughter’s condition, a hole in her spine above the last three to four vertebras.

“We looked at it (the defect) on a normal ultrasound and then with the 3-D, and it seems so much more clear in 3-D,” Walbaum said. “You could see how the skin is forming around the hole, and it helped me prepare for what I’m going to see when she’s born. I’m more comforted about it now after being able to see it in 3-D. I wouldn’t have known what to expect otherwise.”

The 3-D ultrasounds have also been exciting for Walbaum, who didn’t have this kind of technology available with her previous pregnancy.

“When we went in for our 38-week checkup, it was really amazing how well you could see her,” she said. “You could see her chubby cheeks and her eyes and mouth moving. Looking at the 3-D, we can even kind of tell a little bit who she looks more like. It’s so neat to be able to see that.”

Chambers said having the capability to do 3-D ultrasounds has made her job and her interaction with patients a lot more fun. “Because the images are so much more lifelike, it’s literally added a new dimension to ultrasound,” she said.

Mandsager said 3-D ultrasound images are a most useful tool for doctors and patients during the third trimester and when there is appropriate amount of amniotic fluid around the baby and the baby is “cooperative” (not positioned face down). Because the 3-D images are better during the latter part of pregnancy, the technology is not expected to replace 2-D ultrasounds for effectiveness in screening for fetal abnormalities early in pregnancies, Mandsager said. But as the technology is further developed, he expects doctors to find more uses for it.

“We haven’t used it, but there are some people who are now using some variations of 3-D to look at the fetal heart,” he said. “We anticipate that as the technology develops, there will be other areas where the 3-D can help from a medical standpoint.”