Ultrasounds: an informed choice

There can be a fine line between diagnostic benefit and curiosity risk.

The advancement of technology has given us the ability to do more than we ever imagined and can even be a tool used to comfort or to provide assurance.  Ultrasound is one of those technologies, particularly when used to assess a developing baby.  However, the use of ultrasound is rather new and the effects are not fully understood.  The FDA states,

"Ultrasound waves can heat the tissues slightly. In some cases, it can also produce small pockets of gas in body fluids or tissues (cavitation). The long-term consequences of these effects are still unknown. Because of the particular concern for effects on the fetus, organizations such as the American Institute of Ultrasound in Medicine have advocated prudent use of ultrasound imaging in pregnancy.”

Ultrasound produces thermal, vibrational or mechanical changes that may damage the cells or DNA of an embryo or fetus.  The first trimester is particularly vulnerable as the cells are not yet differentiated.  So the question is why we need to use ultrasound at all?

Ultrasound can be very helpful to clinically identify a multiple pregnancy, fetal viability, fetal abnormalities, fetal masses, placental abnormalities, tumors, fibroid, hydatidiform mole, ectopic pregnancy, and reason for vaginal bleeding.  However, where is the line drawn from enough to understand a clinical case versus merely routine screening? 

Some doctors suggest one, others suggest three, and then some do screenings at every visit.  Ask your doctor or midwife: What are my options should something abnormal be found?  What is the chance of false-positive or false-negative?  Could the results alter the course of the pregnancy or the type of care?  Can I delay the test until my baby is bigger?

It is your right to fully understand the risks and benefits of all tests and screenings, including ultrasound, to you and your baby so that you can make a choice that is right for you.