Ultrasound Imaging During Pregnancy

Abstract

Review by a panel of experts convened by the National Institute of Health (NIH) and the Federal Food and Drug Administration (FDA) resulted in a recommendation for diagnostic ultrasound imaging in about 1/3 of pregnancies only when medically indicated but not routinely. Ultrasound technology, 1st developed for use in submarine warfare sonar devices, is widely used by physicians because of its clinical significance and because it allows seeing intrauterine structures without exposing the fetus to dangerous radiation. Its most important uses include estimating the gestational age for patients with uncertain clinical dates, evaluating fetal growth, determining the cause of vaginal bleeding, determining fetal presentation, identifying multiple gestation, supplementing amniocentesis or other special procedures, diagnosing, confirming fetal death and locating intrauterine devices. Recently, many physicians have been advocating routine ultrasound screening of all pregnancies but this is an issue of concern among leading physicians and the NIH. The panel stressed the urgent need for additional research on the safety and efficacy of the procedure. Many studies that found adverse reactions associated with ultrasound use in humans suffer from sever methodological flaws. The panel recommended ultrasound not to be used for routine screening. Some studies indicate that no clear benefit from routine screening results. The panel's recommendations were criticized for unnecessarily restricting ultrasound use and for inappropriately sanctioning widespread use of the technology. Human Life International, an anti-abortion organization, opposed using ultrasound to detect fetal abnormalities, contending that this would promote abortion. Some abortion opponents, however, believe ultrasound would cause bonding between the mother and the fetus and discourage abortion. The panel underscored the importance of the skill and training of ultrasound examiners. In regard to informed consent, the panel recommended that it be obtained. Further intensive research on the use of ultrasound was highly recommended.