3D Sonography


Three-dimensional sonography is an advanced technique used to evaluate your baby.  The use of 3-D sonography is getting more widespread and its technology is improving.  While not every patient needs 3-D sonography, it may be a useful tool to help evaluate your baby.  A 3-D sonogram provides more realistic pictures of your baby.

Although, one may generate better images of your baby with 3-D sonography, it is more difficult to obtain these images than with typical 2-D sonography.  The quality of 3-D imaging depends on several factors such as the amount of amniotic fluid and the baby’s position.  It often required manipulation of the 3-D image to obtain a useful picture of a baby

Three-dimensional sonography is a useful adjunct to traditional 2-D sonography as a means to evaluate your baby.  Three-dimensional sonography has now advanced so that real-time 3-D images can be seen of your baby.  This is called 4-D imaging.  The development of 4-D imaging has really made the use of 3-D sonography more practical for patient care.  As image acquisition improves and gets faster, 3D/4D imaging will become more common place in obstetric imaging.

Advanced Technology


Fetal therapy is available for several conditions diagnosed in-utero.  Some of the fetal conditions for which treatment is available include: fetal anemia, fetal arrhythmias, fetal tumors, certain birth defects such as neural tube defects, abnormal fluid collections in the fetus and twin-twin transfusion syndrome.

Fetal treatment that is possible may include giving the fetus medication directly, withdrawing unwanted fluid from within the baby, transfusing life-saving blood to an unborn child, placing catheters inside the fetus to drain abnormal fluid collections and lastly fetal surgery.

Fetal surgery is an exciting field of perinatal medicine that has seen significant improvements over the last decade.  Traditionally, fetal surgery was “open” fetal surgery whereby the uterus was opened and the fetus was exposed so that the unborn child could be directly operated upon.  Although this type of fetal surgery is still performed, the trend has been towards minimally invasive fetal therapy or fetoscopy.

Fetoscopy is surgery that is performed on the baby or placenta while still in-utero.  Fetoscopy utilizes very thin scopes to see and operate inside a pregnant uterus.  This type of fetal surgery is performed under local anesthesia and is essentially considered same-day surgery.  Most often only one (and occasionally two) ports of entry into the uterus are required for fetoscopy.  The incisions for fetoscopy are usually a few millimeters and do not require any sutures or staples to close.

Most commonly, fetoscopy is used to treat twin-twin transfusion syndrome or TTTS.  TTTS is a complication of identical twins.  Not all identical twins develop TTTS, in fact only about 15% of such twins develop the disease.  TTTS develops due to an abnormal blood flow pattern between the twins.  This abnormal blood flow can be identified in the placenta with fetoscopy.  TTTS that develops early in pregnancy carries a grave prognosis.  Fortunately, TTTS can be effectively treated with fetoscopy and lasers.  Once inside the uterus, the abnormal blood vessels that can be seen connecting on the placenta in these twins are then “shut down” with the laser, effectively restoring a healthier blood flow between the twins.

Dr. Giannina of Pinnacle Perinatal Care, is one of a handful of physicians throughout the United States who is able to perform such fetoscopy and treat conditions such as TTTS.  We are happy to be able to provide this service locally instead of requiring the patient travel to receive such care.

2D Sonography


Two-dimensional sonography is the usual technique used for a fetal evaluation.  With a 2-D sonogram, one gets the typical black and white images that everyone is used to seeing.  This method of sonography is still the main way that we use to look at babies while in the mother’s womb.

Two-dimensional sonography allows us to take measurements of your baby, review the baby’s anatomy and to observe the baby’s behavior.  This allows us to determine the health and status of your baby.

Yes, with 2-D sonography, we can get you the cute face picture of your baby and determine whether the baby is a boy or girl.

HD Live


HD live imaging is the newest twist on 3-D sonography.  HD live provides the most realistic picture of your baby.  The image that we obtain with HD live is similar to a fetoscopic picture.  In other words, the ultrasound image appears as if we are directly looking at the baby inside the mother’s womb.  We have all seen these types of images in books and on television. We have yet to realize the full potential of HD live imaging but it provides an opportunity for expectant parents to get the most realistic preview of their baby.