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ultrasounds - Page 2

post #21 of 29
Rebecca, as far as the hand-held dopplers, this is the theory:

Imagine ultrasound energy (both dopplers and imaging) being a lightbulb. With imaging ultrasound, the pulses of energy are intermittent, meaning they aren't "on" all the time, but rather like a bulb going off, then on, off then on.

With a handheld doppler, the energy is constant.

If you were to hold your hand over a lightbulb, the one that flickered on and off would produce less heat and energy over time.

Evidently, 20 minutes of imaging ultrasound is equal to about a minute of handheld doppler ultrasound.

Interesting, huh? When I learned that in midwifery school, I was surprised. I thought it would be the other way around.

Here is my Informed Choice sheet on Ultrasound, written by my incredible and intelligent apprentice:

USE OF ULTRASOUND IN PREGNANCY AND BIRTH

What is ultrasound?
Ultrasound is a continuous wave of high frequency non-ionizing (considered low-energy) radiation that passes through the body and bounces off of structures. Their reflections are then interpreted by a transducer to display the info it receives or make it audible.

What is ultrasound used for?
Ultrasound is used in our practice to evaluate fetal heart tones (FHT’s) during pregnancy and labor/birth in the form of a hand held doppler. The doppler probe is placed against the skin directly above the area of the fetus to listen and evaluate FHT’s. You can also choose to have FHT’s evaluated by using a fetascope which is a stethoscope designed specifically to listen to heart tones.

You can also choose to have a visual ultrasound AKA sonogram. A sonogram provides not only auditory FHT’s but a visual picture of the developing baby. This allows for evaluation of growth patterns, anatomy, can help to rule out abnormalities, and can provide assistance with determining an approximate due date if this is not known.

External fetal monitoring (EFM) is used in hospitals for continuous monitoring of the fetal heart rate before, during, and after contractions. There has been no benefit demonstrated with continuous monitoring compared with intermittent monitoring.

What are the risks with ultrasound?
There are studies that have shown possible side effects of ultrasound including premature ovulation, preterm birth, dyslexia, delayed speech development, intrauterine growth retardation (IUGR), damage to the nervous system, reduction in the rate of cell division, and less right handedness.

Ultrasound also causes an effect called cavitation where the small pockets of gas that exist in our tissue vibrates and then collapses. The effects of cavitation in human tissue are unknown at this time.

Since the routine use of ultrasound has been used for only 20 years, we have yet to find out what effects ultrasound will have on fetuses in the long term. Even the intensity of ultrasound has grown over time and so we will not find out long term effects on the babies of today until many years from now.

Because every fetus is different, they may have individual tolerances to the amount of ultrasound that they can be exposed to. A “safe” exposure of ultrasound to one fetus may be a very dangerous exposure to another especially in babies who may already have an impaired nervous system or predisposition to some of the other side effects listed previously.

Ultrasound is not associated with gross abnormalities such as mutation to the limbs, organs, brain, etc.

The FDA at this time has set limits on the maximum allowable exposure to ultrasound but these limits are based on exposure to soft tissue and not growing bones. They have not released any info stating that routine use of ultrasound is safe.

Other disadvantages of sonograms are false positives of fetal abnormalities and incorrect dating for due dates.


I/We have read the info that my midwife has provided on the use of ultrasound during my pregnancy and labor/birth and she has explained to us her preference to use fetascopes during pregnancy and a doppler during labor/birth.

I/We understand that there are many unknowns as far as how ultrasound can affect humans long term and we choose to give permission to use a doppler during labor/birth.
post #22 of 29
Interesting....

I wonder about the ones they use in chiropractic offices too, to warm up the tissues. Probably the same sort of thing.

Well, thanks for the info. Is it legal to not be able to find a heartbeat, or I should say to not have a heartbeat recorded for every visit in case the paperwork needs to be looked over later? Do you have problems with fetoscopes yourself?

I guess I'd say I'm leaning toward not using one this time.
post #23 of 29
Yeah, in fact they use ultrasound for carpal tunnel, because it does warm up the nerves, etc. It's the same type of technology that is used to measure vascular pressure and function.

You know, I'm not sure why we do prenatal heartbeats. I guess for some affirmation that the baby is there and alive. However, if mom is feeling lots of movement, why bother? Sometimes I wonder. I usually palpate belly first and most babies respond so playfully and are so active, hearing the heartbeat is almost just for the parents. Until late in pregnancy, when it's nice to know what your baby's particular baseline is, I wonder why we do it (however, I often wonder why we do most things....).

I have a few clients that only want the fetoscope prenatally. If I don't hear baby, I just chart that. No big deal. I also give my clients their own fetoscope to borrow from mid-preg to birth so they can listen on their own whenever they want. This helps when sometimes you want a bit of reassurance or want gramma to hear the heartbeat, etc.

There's no legal requirement really, although with my license, I'm supposed to listen to fetal heart tones. However, I'm also supposed to weigh clients and I don't believe in that.
post #24 of 29
Hi there, just wanted to chime in my two lay, unscientific cents. First, the only articles I've seen even questioning the safety and benefits and necessity of ultrasound came from Peggy O'Mara. The Mothering article was mentioned earlier and then her recent pregnancy book. I've never heard anyone else, except my dh, even question them. It seems everyone gets one and proudly displays it! We are expecting #2 in two weeks and have never had one.

Also, we only used the fetoscope, except in labor and when I had some early 2nd trimester bleeding. It takes longer to hear the heartbeat, but I do usually feel movement and that's all I need to know baby is active and alive. So basically, no handheld until the baby is on it's way out.

Though when I had the bleeding, it was very reassuring to hear the baby. I was too freaked out to feel confident about the baby's movement b/c it had just started moving earlier that week.
post #25 of 29
Quote:
Originally posted by pamamidwife
However, I'm also supposed to weigh clients and I don't believe in that.
Off topic...

I'm so happy to hear that a care provider is not obsessed with a woman's weight during pregnancy! Bless you!
post #26 of 29
Quote:
Originally posted by pamamidwife

Some placentas haVe multiple lobes - usually two. There can be Vessels running from the "main" placenta to the "satellite" placenta. This usually is an issue only with the birth of the placenta - where the satellite placenta remains in utero and oftentimes the exposed Vessels cause significant bleeding and hemorrhage. It sounds like, Mssgirl, that this is what you had - with the additional "bonus" (ugh! I cannot belieVe you went through that! how scary!) of haVing a true Vasa preVia oVer the cerVix because of this low-lying satellite placenta/lobe.

THanks so much pamamidwife!!! Yes I was considered a true "lab rat" during this pregnancy. Docs from all over Texas were being called on for consultation. My tests, reports and my placenta were all saved so they could
be studied.
But believe it or not, with all the potential scariness that could have happened....not one bad thing happened. My doc told me not to laugh, cough, have sex, strain to use the bathroom or pick up anything for the 7 months I knew about it or something catostrophic could happen. How'd you like to have THAT on your shoulders for that length of time (and have a toddler running around the house ).

I consider myself very lucky for sure!

Besides ds2 coming from the mess......my mom paid for me to have a cleaning service come to my house during that time!:LOL
post #27 of 29
My cousin's first child has a severe neural tube defect that was detected by ultrasound. His spinal cord formed outside his body and in all likelihood (according to her ob and neurosurgeon) he would not have survived labor or a vaginal delivery.

He was born by scheduled C-section and underwent several surgeries very early on. He's of normal intelligence and uses a wheelchair and they're just very glad they had the opportunity to make choices that saved and enhanced his life.

We had ultrasounds with dd and ds (due early April) because I felt as though I wanted to see that their bodies and brains were intact and healthy. (Insofar as ultrasound can reveal this, of course!) Although I am technically not at much higher risk for a neural tube defect in my children, the family history gave me pause. For us, it was worth it. We've had one per kid, and that's my limit.
post #28 of 29
I just wanted to add a thought. I am due to have babe #2 in February. With DS we had an ultrasound, he is fine. With this pregnancy I declined an ultrasound, now that I am a more informed Mama.
From what I have read routine ultrasounds(sonograms) have become the norm but are not documented anywhere that they are to be routine. The American guidlines have ultrasound used as testing if a problem is found or there is reason to believe there may be a problem. This is due to the fact that they really dont know the side effects of sonograms.
Now most OB's in my area are routinly giving womyn ultrasounds early on (8weeks I think) to determine due date, etc. All of that info can be found thru a palpation exam.
Just my thoughts. I really thought a lot about this at the beginning if this pregnancy and there is no supporrting data that says a low risk pregnancy should have one. Luckily with a midwife you dont have to fight your decisions.
post #29 of 29
we had 5 ultasounds with baby #1
1 to detemine time of conception
2 couldn't find heartbeat (thankfully her butt was in the way!)
3 gender..no luck..butt again..
4 gender..its a girl!
5 position of the baby

talk about an u/s happy OB!

she came out perfect and is rarely sick....but thats just my experience....

this time we only got one...b/c I was huge at 8 wks and midwife had to r/o twins....but thats IT this time...we're not even gonna find out the gender!...can't wait!
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