Aberration correction in fetal ultrasound: Clinical evaluation on image quality improvement

OBJECTIVE: Obstetric ultrasound is key for assessing fetal growth and detecting anomalies, with image quality critical for diagnostic accuracy. Maternal body mass index (BMI) and other factors can impair quality. Aberration correction (AC) aims to reduce image quality degradation. This prospective observational study assessed the effect of AC on fetal ultrasound image quality and biometric measurements. METHODS: Routine ultrasound images of the fetal head, abdomen, and heart were analyzed. The image quality score (IQS) and biometric measurements, including the circumference of the head, abdomen, and heart, were compared before and after AC. Intraclass correlations (ICC) were used to describe intra- and inter-observer agreement of measurements. Secondary objective evaluated IQS subcomponents and outcomes stratified by BMI. RESULTS: The study included 186 images from 62 patients. IQS were significantly higher in AC-images (median 14) compared with no-AC images (median 13.5), with significance observed across both BMI groups and a more pronounced effect in the normal BMI group. Intra- and inter-observer agreement for cardiac circumference improved after AC (0.907 to 0.987 and 0.873 to 0.925). For other measurements, agreement was excellent (>0.9) regardless of AC or BMI. CONCLUSION: Aberration correction improved obstetric ultrasound by enhancing image quality and increasing the reliability of biometric measurements, particularly of smaller fetal structures. The results highlight the clinical potential of AC and lay the foundation for future research to assess its role in clinical practice.