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Beginnings Pregnancy Guide Update: “Entertainment Ultrasound” Warning

Choose 2D, 3D or 4D.  In-studio or at your baby shower. Announce your pregnancy with a “viewing party”. Get a video at the mall. Post it on Facebook. Select the premium package offered by a Miami OB-GYN’s office and get a weekend discount.
 
The American Institute of Ultrasound Medicine, American College of Obstetricians and Gynecologists, American Academy of Family Physicians, March of Dimes, US Food and Drug Administration, England’s National Institute for Health and Clinical Excellence, the UK’s National Collaborating Centre for Women's and Children's Health, and other national and international experts all have published strong recommendations against non-medical use of fetal ultrasound.  The Society of Obstetricians and Gynaecolgists of Canada calls for a complete ban on non-medical use of fetal ultrasound. The state of Connecticut legislated a ban in 2009.  The FDA says that creating fetal keepsake ultrasound images is “an unapproved use of a medical device,” and those who perform ultrasonography scans “without a physician’s order may be in violation of state or local laws or regulations.”
 
“You don’t need an excuse to be happy.”
Still internet ads for non-medical ultrasounds abound, complete with slogans like this, implying you don’t need a medical reason for the “painless, relaxing procedure”. The growing popularity of “keepsake ultrasounds” is not due to cost or access issues. Most insurance companies pay for one or two doctor-ordered ultrasounds as part of routine prenatal care, and commercial ultrasound is not cheap.
 
Prices start at $175 for the 3D in-studio option. $500 for an “ultrasound party” at the location of your choice. The cheapest rate I saw was $75 for a basic “gender determination” scan; it’s discounted to  $55 on Saturdays one OB-GYN’s office. These commercial services are not regulated or standardized.
 
Safety Concerns
Commercial sonographers say that ultrasound is safe. I found unclear statements like: “All research provided has been proven to be safe for expectant mothers and baby, as long as the procedure is done by a trained professional, and no longer that one hour intervals.”   First, we have to ask, research provided by whom? and What about the research that was not provided?  Second, remember that no research ever proves  anything. It can only offer statistical evidence. Then, a more accurate statement is that repeated ultrasounds have not been proven harmful. Still  the evidence has convinced all the advisory and regulatory agencies that entertainment ultrasounds are worrisome.
 
Ultrasound uses sound waves, not xrays. So radiation is not the issue. But the procedure targets the fetus with heat and  pressure, especially prolonged, 4-D studies. New York state legislators proposed a ban on ultrasonography for entertainment purposes, citing data showing that 4Dl ultrasound equipment can emit eight times more energy than the machines commonly used in medical settings. The risk of  effects on fetal development has been demonstrated in both human and animal models, and remains, at least theoretically, so that  the FDA concludes exposing the fetus to ultrasound with no anticipation of medical benefit is not justified.
 
Additional concerns about non-medical ultrasonography include the possibility that non-medical ultrasonography will fail to identify a problem with the baby, falsely reassuring the patient and her family; or that a false-positive result could create unnecessary anxiety and follow-up testing. Machines are unregulated so may not be properly calibrated or maintained. Technicians may not be well-trained or proficient. “gender determination” had never been an accepted use of of ultrasound technology and raises thorny ethical issues.
 
Medical ultrasounds are for doctors           
Here’s the problem:  In medical settings, the sonographer is commonly prohibited from explaining ultrasound results to the patient, who must then wait for days or weeks to get the results from the physician who ordered the scan. Family members may be barred from attending the ultrasound appointment to avoid congestion in the radiology department. Parents may not receive still pictures or video to take home. If they do, they still cannot send it to a friend or post it online.  Until these disempowering practices change, parents and  sonographers  will continue to seek a more informative,  convenient, family friendly experience.

Check  Technician’s Credentials                      
Qualified sonographers are trained and certified. Find one, or check a technician’s credentials,  at  the American Registry for Diagnostic Medical Sonography (ARDMS) 

Beginnings Pregnancy Guides says, “Ultrasound is safe for you and Baby.”  [p8] That remains true. The 2014 edition will add this statement: Many healthy pregnancies do not need ultrasound. Extra  “keepsake" ultrasounds may be harmful.  The Registry of credentialed sonographers will be posted on the new Mothers’  Resources page at www.BeginningsGuides.com More on that later.

References:  http://www.aafp.org/afp/2005/1201/p2362.html#afp20051201p2362-b6
http://www.ct.gov/governorrell/cwp/view.asp?A=3675&Q=442298
 
www.guideline.gov/content.aspx?id=14306&search=ultrasound+pregnancy#Section427
 
 
 
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