1. Structural and functional early human development assessed by three-dimensional and four-dimensional sonography 
Asim Kurjak, M.D., Ph.D., Ritsuko K. Pooh, M.D., Ph.D., Luis T. Merce, M.D., Jose M. Carrera, M.D., Ph.D., Aida Salihagic-Kadic, M.D., Ph.D., Wiku Andonotopo, M.D. 
Fertility and Sterility 
Volume 84, Issue 5, Pages (November 2005)
DOI: /j.fertnstert
Copyright © 2005 American Society for Reproductive Medicine Terms and Conditions

2. FIGURE 1
Normal morphological development of embryos from 5 to 10 weeks of gestation.
Kurjak. Early human development assessed by 3D and 4D sonography. Fertil Steril 2005.
Fertility and Sterility  , DOI: ( /j.fertnstert )
Copyright © 2005 American Society for Reproductive Medicine Terms and Conditions

3. FIGURE 2
Fetus at 11 weeks showing movement of upper and lower extremities (A–D).
Kurjak. Early human development assessed by 3D and 4D sonography. Fertil Steril 2005.
Fertility and Sterility  , DOI: ( /j.fertnstert )
Copyright © 2005 American Society for Reproductive Medicine Terms and Conditions

4. FIGURE 3
Three-dimensional surface view of the fetus at 12 weeks gestation. (A) Note the regularity of the anterior abdominal wall, because the midgut has returned into the abdomen. (B) Three-dimensional surface view of a fetus with hydrocephalus at 12 weeks’ gestation. Details of the face such as the nose, orbits, maxilla, and mandible are visible together with overall enlargement of the head.
Kurjak. Early human development assessed by 3D and 4D sonography. Fertil Steril 2005.
Fertility and Sterility  , DOI: ( /j.fertnstert )
Copyright © 2005 American Society for Reproductive Medicine Terms and Conditions

5. FIGURE 4
(A) A 3D view of an 11-week-old fetus with thickened nuchal translucency (red arrows). (B) An 11-week-old fetus with thickened nuchal translucency (white arrows).
Kurjak. Early human development assessed by 3D and 4D sonography. Fertil Steril 2005.
Fertility and Sterility  , DOI: ( /j.fertnstert )
Copyright © 2005 American Society for Reproductive Medicine Terms and Conditions

6. FIGURE 5
Prune belly syndrome at 11 weeks of gestation. Three orthogonal views and 3D surface image. Enlarged prune belly-like bladder is detected. Right photo shows aborted fetus at 12 weeks of gestation. Fetal karyotype was normal.
Kurjak. Early human development assessed by 3D and 4D sonography. Fertil Steril 2005.
Fertility and Sterility  , DOI: ( /j.fertnstert )
Copyright © 2005 American Society for Reproductive Medicine Terms and Conditions

7. FIGURE 6
Exstrophy of the bladder in the first trimester. (Upper) 2D sagittal (A), coronal (B), and coronal color Doppler image (C). Extracorporeal cyst (arrowheads) is seen. Note the umbilical arteries running along the cyst. (Lower) 3D images at 10 weeks (D), 11 weeks (E), and 12 weeks (F) of gestation. Longitudinal images show gradual but rapid increase of the outside cyst. No bladder was seen inside of the fetus.
Kurjak. Early human development assessed by 3D and 4D sonography. Fertil Steril 2005.
Fertility and Sterility  , DOI: ( /j.fertnstert )
Copyright © 2005 American Society for Reproductive Medicine Terms and Conditions

8. FIGURE 7
Severe scoliosis at 12 weeks of gestation. (A) 3D image of fetal back. Severe scoliosis is demonstrated. (B) Back view of aborted fetus. Fetal karyotype was normal.
Kurjak. Early human development assessed by 3D and 4D sonography. Fertil Steril 2005.
Fertility and Sterility  , DOI: ( /j.fertnstert )
Copyright © 2005 American Society for Reproductive Medicine Terms and Conditions

9. FIGURE 8
Pleural effusion at 9 weeks of gestation. Three orthogonal views (A–C) and 3D surface image (D). Bilateral pleural effusion is clearly demonstrated. Fetal heart beat was normal and regular. Fetal demise was confirmed 3 days later and villous karyotype was 45,X, Turner syndrome.
Kurjak. Early human development assessed by 3D and 4D sonography. Fertil Steril 2005.
Fertility and Sterility  , DOI: ( /j.fertnstert )
Copyright © 2005 American Society for Reproductive Medicine Terms and Conditions

10. FIGURE 9
A 3D surface image of nonimmuned hydrops fetalis at 10 weeks of gestation.
Kurjak. Early human development assessed by 3D and 4D sonography. Fertil Steril 2005.
Fertility and Sterility  , DOI: ( /j.fertnstert )
Copyright © 2005 American Society for Reproductive Medicine Terms and Conditions

11. FIGURE 10
A 3D surface image of cystic hygroma at 11 weeks of gestation.
Kurjak. Early human development assessed by 3D and 4D sonography. Fertil Steril 2005.
Fertility and Sterility  , DOI: ( /j.fertnstert )
Copyright © 2005 American Society for Reproductive Medicine Terms and Conditions

12. FIGURE 11
A 3D surface image of conjoined twins at 11 weeks of gestation.
Kurjak. Early human development assessed by 3D and 4D sonography. Fertil Steril 2005.
Fertility and Sterility  , DOI: ( /j.fertnstert )
Copyright © 2005 American Society for Reproductive Medicine Terms and Conditions

13. FIGURE 12
Acrania at 10 weeks of gestation. A 2D ultrasound coronal image at 10 weeks (A). Note the normal appearance of amniotic membrane, which indicates that this condition is not amniotic band syndrome. A 3D ultrasound image of the same fetus as left image (B).
Kurjak. Early human development assessed by 3D and 4D sonography. Fertil Steril 2005.
Fertility and Sterility  , DOI: ( /j.fertnstert )
Copyright © 2005 American Society for Reproductive Medicine Terms and Conditions

14. FIGURE 13
Spina bifida at 9 weeks of gestation. (Left) 2D sagittal image. Cystic formation was seen (white circle) at lumber part. (Right) 3D image of neural tube. Clear dilatation of the neural tube is demonstrated (arrows).
Kurjak. Early human development assessed by 3D and 4D sonography. Fertil Steril 2005.
Fertility and Sterility  , DOI: ( /j.fertnstert )
Copyright © 2005 American Society for Reproductive Medicine Terms and Conditions

15. FIGURE 14
Omphalocele at 12 weeks of gestation. A 3D surface image of the fetus (A). Omphalocele was seen at the left side of the fetus. Aborted fetus (B). Sac of omphalocele was ruptured on delivery. Fetal chromosome was normal.
Kurjak. Early human development assessed by 3D and 4D sonography. Fertil Steril 2005.
Fertility and Sterility  , DOI: ( /j.fertnstert )
Copyright © 2005 American Society for Reproductive Medicine Terms and Conditions

16. FIGURE 15
The yolk sac is the primary source of exchange between the mother and the embryo. It has nutritive, metabolic, endocrine, immunological, excretory, and hematopoietic functions. At the beginning of the 7th week, using 3D ultrasound it becomes visible as the first structure inside the chorionic cavity.
Kurjak. Early human development assessed by 3D and 4D sonography. Fertil Steril 2005.
Fertility and Sterility  , DOI: ( /j.fertnstert )
Copyright © 2005 American Society for Reproductive Medicine Terms and Conditions

17. FIGURE 16
On 4th and 5th week of the normal pregnancy, endometrium more (A) or less (B) vascularized but it always is possible to distinguish a 3D color signal penetrating to gestational sac. We named this finding the “comet sign” and it indicates the implantation site.
Kurjak. Early human development assessed by 3D and 4D sonography. Fertil Steril 2005.
Fertility and Sterility  , DOI: ( /j.fertnstert )
Copyright © 2005 American Society for Reproductive Medicine Terms and Conditions

18. FIGURE 17
Uterochorionic and intrachorionic circulation at 12th week of normal pregnancy. From 6 weeks we can differentiate between uterochorionic (i.e., spiral and radial vessels, red arrow) and intrachorionic (i.e., intervillous blood flow, white arrow) circulations. (A) Transparent mode of 3D power Doppler mapping. (B) Color mode of 3D power Doppler angiography.
Kurjak. Early human development assessed by 3D and 4D sonography. Fertil Steril 2005.
Fertility and Sterility  , DOI: ( /j.fertnstert )
Copyright © 2005 American Society for Reproductive Medicine Terms and Conditions

19. FIGURE 18
Uterochorionic, intervillous, and fetal circulation at 8th (A) and 10th week (B) of pregnancy. UCV = uterochorionic (spiral and radial) vessels; IVF = intervillous blood flow; UV = umbilical vessels; H = heart; DV = ductus venosus; CV = cerebral vessels; ACV = antichorionic vessels.
Kurjak. Early human development assessed by 3D and 4D sonography. Fertil Steril 2005.
Fertility and Sterility  , DOI: ( /j.fertnstert )
Copyright © 2005 American Society for Reproductive Medicine Terms and Conditions

20. FIGURE 19
Developing brain and spinal cord during pregnancy. Fetal central nervous system changes in size and appearance from early premature structure into late mature structure with gyral formation. CH = cerebral hemisphere; C = cerebellum; D = diencephalons; M = medulla; SC = spinal cord; f = forebrain; mb = midbrain.
Kurjak. Early human development assessed by 3D and 4D sonography. Fertil Steril 2005.
Fertility and Sterility  , DOI: ( /j.fertnstert )
Copyright © 2005 American Society for Reproductive Medicine Terms and Conditions

21. FIGURE 20
Normal intracranial structure at 8 weeks of gestation in parallel cutting slices of three orthogonal views. Sagittal (A), coronal (B), axial sections (C) from above. The ventricular system is visible.
Kurjak. Early human development assessed by 3D and 4D sonography. Fertil Steril 2005.
Fertility and Sterility  , DOI: ( /j.fertnstert )
Copyright © 2005 American Society for Reproductive Medicine Terms and Conditions

22. FIGURE 21
Early stage of Dandy Walker malformation at 11 weeks of gestation. Abnormal dilatation of the posterior fossa (arrowheads) (A–C). Upper right figure is a sagittal image at the same gestational age in a normal case. Amniocentesis revealed trisomy 9 mosaicism and the fetus died in utero at 19 weeks.
Kurjak. Early human development assessed by 3D and 4D sonography. Fertil Steril 2005.
Fertility and Sterility  , DOI: ( /j.fertnstert )
Copyright © 2005 American Society for Reproductive Medicine Terms and Conditions

23. FIGURE 22
Fetal movement at 10 weeks and 6 days. Active arm movements (A–E) are associated with active body and lower limb movement. Despite active movements of glenohumeral and elbow joints at this stage, wrist and finger movements were not visualized in most cases.
Kurjak. Early human development assessed by 3D and 4D sonography. Fertil Steril 2005.
Fertility and Sterility  , DOI: ( /j.fertnstert )
Copyright © 2005 American Society for Reproductive Medicine Terms and Conditions

24. FIGURE 23
Fetus at 11 weeks still opens the palms but five digits are no longer on the same layer (A). Mild adduction of the thumb and atonic fingers were observed and the palm appearance was clearly different from that in 9 and 10 weeks (B).
Kurjak. Early human development assessed by 3D and 4D sonography. Fertil Steril 2005.
Fertility and Sterility  , DOI: ( /j.fertnstert )
Copyright © 2005 American Society for Reproductive Medicine Terms and Conditions

25. FIGURE 24
Clench (A) and unclench (B) of the fist at 12 weeks. At this stage, fetuses start to clench and unclench their fists.
Kurjak. Early human development assessed by 3D and 4D sonography. Fertil Steril 2005.
Fertility and Sterility  , DOI: ( /j.fertnstert )
Copyright © 2005 American Society for Reproductive Medicine Terms and Conditions

26. FIGURE 25
A 4D ultrasound sequence of the fetus at 12 weeks of gestation showing general movements (A–F). The complex movements of the limb, trunk, and head are visible causing a shift in fetal position.
Kurjak. Early human development assessed by 3D and 4D sonography. Fertil Steril 2005.
Fertility and Sterility  , DOI: ( /j.fertnstert )
Copyright © 2005 American Society for Reproductive Medicine Terms and Conditions