title: Parental artistic drawings of the fetus before and after 3-/4-dimensional ultrasonography.
abstract: OBJECTIVE
  The purpose of this study was to assess the impact of 3-/4-dimensional ultrasonography (3D/4DUS) on parental impressions of their fetus using preexamination and postexamination parental drawings.
  
  
  METHODS
  One hundred one parents (32 male and 69 female) were asked to draw pictures of their fetus immediately before and after undergoing 3D/4DUS. A drawing assessment instrument was used to evaluate the fetal anatomy by 4 reviewers. Overall descriptive quality and a comparison of before and after images were assessed.
  
  
  RESULTS
  Reviewers judged the drawings as significantly different in 23% to 56% of cases, slightly different in 41% to 64%, and having no significant difference in 2% to 22%; some difference was identified in at least 78%. Reviewers familiar with ultrasonography were able to correctly predict which picture was drawn first in 78%. Differences identified were related to extremity positioning, personalized uterine environment, and artistic nature. No significant difference in the overall total scoring for anatomic differentiation before and after 3D/4DUS was found. A trend in drawing less anatomic structures after 3D/4DUS was discovered. Significantly fewer people drew hair after 3D/4DUS (P<.01) even when they had drawn hair before the 3D/4DUS. Similar significant differences were seen for the lower extremities (P<.01), with less detail being presented after the 3D/4DUS.
  
  
  CONCLUSIONS
  Differences were seen between drawings made before and after 3D/4DUS by parents. Drawings after 3D/4DUS emphasized structures seen during the 3D/4DUS examination and were more reality based, whereas drawings before 3D/4DUS were more iconographic and based on preconceived anatomic knowledge.
authors.affiliation: Department of Radiology, University of California, San Diego, 9300 Campus Point Dr, 7756, La Jolla, CA 92037, USA. dpretorius@ucsd.edu
authors.forename: Dolores H
authors.initials: DH
authors.lastname: Pretorius
authors.forename: Heather A
authors.initials: HA
authors.lastname: Hearon
authors.forename: Kathryn A
authors.initials: KA
authors.lastname: Hollenbach
authors.forename: Eun-Kyung
authors.initials: EK
authors.lastname: Ji
authors.forename: Shilpa
authors.initials: S
authors.lastname: Gattu
authors.forename: Novella M
authors.initials: NM
authors.lastname: Nelson
authors.forename: Tanya M
authors.initials: TM
authors.lastname: Nelson
authors.forename: Jason
authors.initials: J
authors.lastname: Chibuk
authors.forename: Andrew D
authors.initials: AD
authors.lastname: Hull
authors.forename: Ruth P
authors.initials: RP
authors.lastname: Newton
authors.forename: Thomas R
authors.initials: TR
authors.lastname: Nelson
mesh_terms: D005260:Female; D005333:Fetus / Q000033:anatomy & histology*; D006801:Humans; D021621:Imaging, Three-Dimensional; D008297:Male; D010287:Parent-Child Relations; D010290:Parents / Q000523:psychology*; D011247:Pregnancy; D016216:Ultrasonography, Prenatal / Q000379:methods