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How safe are ultrasound exams?



DEAR DR. ROACH: Could you please discuss the use of ultrasounds during routine pregnancies? How many typically are performed, and are there any possible negative effects on the fetus? Are doctors today performing more ultrasounds (including 3-D ultrasounds) just because they can and because it’s exciting for the expectant parents, or is there a medical reason for performing these?

My daughter-in-law is in her sixth month and has had two ultrasounds, plus a 3-D session. She is under the impression that she will have at least one more. To my knowledge, this is not a high-risk pregnancy (she’s 26 and everything is going fine). I’m just wondering if so many sessions are really needed and what is known about the effects on the fetus. — G.M.

ANSWER: There is some controversy over whether an ultrasound poses risks to the developing fetus. The Food and Drug Administration has noted that there may be some heating of tissues and that any long-term risks are unknown. I did find studies showing that there is no long-term risk of leukemia, hearing loss or abnormal eye development.

A 2013 guideline from multiple groups, including the American College of Obstetricians and Gynecologists, recommended a standard first-trimester ultrasound, and a standard second- or third-trimester ultrasound. Any other ultrasounds would be based on a clinician’s concern for a potential problem.

The guideline specifically states: “Fetal ultrasound should be performed only when there is a valid medical reason, and the lowest possible ultrasonic exposure settings should be used to gain the necessary diagnostic information.” I don’t have enough information to know why your daughter-in-law has had more ultrasounds than is usually recommended for a normal pregnancy. Perhaps her obstetrician has a low-level concern she hasn’t shared with her, or your daughter-in-law with you.

While not the case for her, I am concerned about the growing trend of so-called keepsake ultrasounds that are not performed for valid medical reasons, such as those done in shopping malls. These might not be administered with the same degree of expertise and safety as a medical ultrasound.

Dr. Roach regrets that he is unable to answer individual letters, but will incorporate them in the column whenever possible. Readers may email questions to ToYourGoodHealth@ med.cornell.edu. To view and order health pamphlets, visit www.rbmamall.com, or write to Good Health, 628 Virginia Drive, Orlando, FL 32803.

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