Three-dimensional ultrasound and maternal bonding, a third trimester study and a review

Prenat Diagn. 2013 Jan;33(1):81-8. doi: 10.1002/pd.4013. Epub 2012 Nov 20.


Objective: To compare the effect of third trimester three-dimensional and four-dimensional (3D/4D) versus two-dimensional (2D) ultrasound (US) of the fetal face on maternal bonding. Studies quantifying the psychological effect of 3D/4D US on mothers, pregnant of a fetus with no detectable abnormalities, were reviewed.

Methods: One hundred sixty Caucasian women attended a third trimester 3D/4D or 2D US examination. Women filled out the Maternal Antenatal Attachment Scale (MAAS) 1 to 2 weeks before (MAAS1) and 1 to 2 weeks after (MAAS2) the US examination. Visibility, recognition and attractiveness were assessed.

Results: Within both US groups, the MAAS2 scores were significantly higher than the MAAS1 scores (p < 0.0001). No differences in MAAS scores between the US groups emerged. Visibility and recognition were significantly positively related with the increase in MAAS scores (p = 0.003 and p = 0.042) in the 3D/4D group. Of 13 psychological studies, eight studies evaluated bonding and found no difference between 3D/4D and 2D US. The effect of 3D/4D US on satisfaction or perception showed conflicting results, and on anxiety/stress, reduction was the same as after 2D US.

Conclusions: Bonding increases after either a 3D/4D or 2D US. The effect of 3D/4D US on bonding is stronger at better degrees of visibility and recognition.

Publication types

  • Review

MeSH terms

  • Adult
  • Educational Status
  • Face / diagnostic imaging
  • Face / embryology
  • Female
  • Humans
  • Imaging, Three-Dimensional* / psychology
  • Maternal-Fetal Relations / psychology*
  • Object Attachment*
  • Pregnancy
  • Pregnancy Trimester, Third
  • Ultrasonography, Prenatal / methods*
  • Ultrasonography, Prenatal / psychology