FDA warns against "keepsake" ultrasounds - Mothering Forums
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#1 of 43 Old 08-20-2007, 09:26 PM - Thread Starter
 
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http://www.fda.gov/FDAC/features/2004/104_images.html

It's fairly long so I'll just post the last paragraph. I suggest anyone thinking about 3D or 4D ultrasounds to read it.

"The prescription status of ultrasound equipment ensures that pregnant women will receive professional care that contributes to their health and to the health of their babies. Performing prenatal ultrasounds without following state and federal guidelines puts a mother and her unborn baby at risk. Therefore, the procedure should only be used to provide medical benefit. Besides being inappropriate and contrary to responsible medical practice, the bottom line is: Why take a chance with your baby's health for the sake of a video?"
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#2 of 43 Old 08-20-2007, 10:13 PM
 
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They've been saying this for years. U/s should be saved for situations where there is a medical need.

This is why I'm against routine u/s.

-Angela
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#3 of 43 Old 08-21-2007, 01:50 AM
 
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I think there's a difference between "routine ultrasounds" and "keepsake ultrasounds."

I, personally, believe in routine ultrasound to look at the basics of the baby's anatomy (4 chambered heart, diapragm intact, spine intact, abdominal contents inside the abdomen, etc.), it's certainly no guarantee (things can and do get missed on ultrasound) but I think it's worth it. But, each mom has to do her own cost/ benefit analysis and do what she believes is right. I started my nursing career with the intention of becoming a nurse-midwife, but my detour through the land of the NICU has left it's mark on me. It's harder to ignore statistical anomalies when you've cared for them, held their parent's hand, watched them get better or watched them go. I've heard many people say that they wouldn't have a routine ultrasound because the results wouldn't change their decision to keep the baby or not, but knowing ahead of time if your child has a life-threatening, but *treatable* illness can change your plans about where you deliver and give you more time to research treatment options.

But I agree that "keepsake ultrasounds" that are not medically indicated (i.e. as follow up to something concerning found on the routine 18-22 week ultrasound or in response to some other concerning finding --polyhydramnios, oligohydramnios, etc.), are unnecessarily risky.
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#4 of 43 Old 08-21-2007, 02:09 AM
 
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"Routine" u/s are not with medical reason IMO. I would not do them without a reason.

Personally I see them very much on the same level with "keepsake" u/s

-Angela
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#5 of 43 Old 08-21-2007, 02:23 AM
 
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Here's the part that scares me:

"Facilities with captivating names such as Fetal Fotos, Peek-a-Boo, Womb with a View, and Baby Insight are popping up in strip malls and shopping centers all over the country. "

Strip malls? Ack! Cutesy names? Yikes! Creepy.

I did a 20 week u/s as my only prenatal testing. I'm planning a homebirth and wanted to make sure there were no serious things I needed to know about my baby. That's medical to me. Yes I also wanted to know gender but that was a bonus... I wanted to know birthing my baby outside of the hospital was safe. Boom...medical reason.
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#6 of 43 Old 08-21-2007, 02:24 AM
 
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You know, also? Those 4-D things just look creepy!
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#7 of 43 Old 08-21-2007, 02:29 AM
 
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Quote:
Originally Posted by Grace24 View Post
You know, also? Those 4-D things just look creepy!
Yes. They really weird me out, too.
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#8 of 43 Old 08-21-2007, 03:37 AM
 
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got to agree also. I tend to have 2. One to date the baby & one to check that all looks good (even though not perfect), I think this is because I have had pregnancies that did not go well & it comforts me so I relax a little. One of my SIL's had a 4-d one, also agree that it looks creepy.

I don't have keepsake u/s's because after a few months I have trouble remembering what is supposed to be what on the 'picture'. Anyone else like that?
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#9 of 43 Old 08-21-2007, 03:41 AM
 
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Quote:
Originally Posted by alegna View Post
"Routine" u/s are not with medical reason IMO. I would not do them without a reason.

Personally I see them very much on the same level with "keepsake" u/s

-Angela
Just curious, what do you consider to be a reason?

Maybe I wasn't clear, or maybe we just disagree, but all that I believe in doing is the 18-22week ultrasound to look at baby's anatomy (as Grace24 mentioned), unless there is something else concerning going on. I don't think it's necessary to have multiple USs throughout pregnancy just as a matter of course.
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#10 of 43 Old 08-21-2007, 03:43 AM
 
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Quote:
Originally Posted by Grace24 View Post
Here's the part that scares me:

"Facilities with captivating names such as Fetal Fotos, Peek-a-Boo, Womb with a View, and Baby Insight are popping up in strip malls and shopping centers all over the country. "
WAY creepy. [shudder, shudder]
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#11 of 43 Old 08-21-2007, 04:07 AM
 
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how rude would it be for me to send this to a friend who has declared her intention to have a 3D/4D u/s? don't know if she has already had it.
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#12 of 43 Old 08-21-2007, 04:57 AM
 
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I will say this for those strip mall 3D ultrasound places... they're a hell of a lot cheaper than any radiology clinic!

I'd planned to not have any ultrasounds this pregnancy (also believe it should just be in case there's a medical reason, not just a standard test), but when at 36 weeks, the MW couldn't tell if baby was breech or not... well, it was time for an ultrasound. All of the radiology clinics I called would charge me about $400, so I called a place in Redmond WA called "Baby Pictures" and they did it for $75. The tech was very friendly, and assured us that if she saw anything 'wrong' she would contact our MW, but it wasn't a medical ultrasound. All we needed to find out if it was a head digging into my pelvis, or a butt (it was a head!).

Also, even those standard 18-22 week ultrasounds never seem to be the only ones you go for. That was the plan with DS, but I still ended up with FOUR ultrasounds. The first: standard, second: check position at 32 weeks, third: non-stress test, fourth: while in labor at a hospital. Docs pull those things out far too often.

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#13 of 43 Old 08-21-2007, 07:09 AM
 
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The problem with routine 18-22 week ultrasounds is that they aren't very efficient at picking up on random problems. Ultrasound is far better at looking for a specific problem, say a previous loss caused by a malformed heart, or specific brain problem.

A lot of what they do during an ultrasound seems to be for reasearch purposes. Also, they have a really high rate of false positives (ie. "we think something is wrong with the baby"). I just wasn't willing to put myself through that.

Sorry if this isn't coherent, can't sleep.

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#14 of 43 Old 08-21-2007, 07:19 AM
 
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Quote:
Originally Posted by Twinklefae View Post
Also, they have a really high rate of false positives (ie. "we think something is wrong with the baby"). I just wasn't willing to put myself through that.
I work L&D, not NICU so my experience is much more of the above than of "oh, that G-d we caught it and can make suitable arrangements".
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#15 of 43 Old 08-21-2007, 09:40 AM
 
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I think part of the issue with the keepsake u/s places is that their techs aren't trained and licensed, necessarily, the same way that u/s techs at medical facilities are. Personally, my doctor does all my u/s himself, and only for medical need (unfortunately, I have medical need for more due to cervical and uterine issues).

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#16 of 43 Old 08-21-2007, 10:18 AM
 
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My SIL had a 3d/4d u/s and they put the keepsake pictures on pins for them. Those things are creepy, no way would I wear a pin that makes my baby look like Lord Voldemort. Why would anyone want that?
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#17 of 43 Old 08-21-2007, 11:45 AM
 
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Quote:
Originally Posted by mischievium View Post
Just curious, what do you consider to be a reason?

Maybe I wasn't clear, or maybe we just disagree, but all that I believe in doing is the 18-22week ultrasound to look at baby's anatomy (as Grace24 mentioned), unless there is something else concerning going on. I don't think it's necessary to have multiple USs throughout pregnancy just as a matter of course.
We just disagree. I don't think that just taking a look is a valid medical reason. I think they are horribly overused.

A medical reason would include (IMO): dating when there is NO clue (still nursing, really odd cycles etc), bleeding, multiples suspected, significant family history of a medical issue that could be detected, etc.

-Angela
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#18 of 43 Old 08-21-2007, 12:02 PM
 
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My cousin had a baby whose intestine was outside of his abdomen. They did a c-section so as not to risk tearing his intestine and there was a crew there ready and waiting to assist him should he have complications. I would just feel more at ease knowing something like this were the case so that he could be taken care of...his intestines had to be covered and kept sterile so that they would not dry out and get infected before they could get him in for surgery. Thankfully he is a happy healthy (albeit crazy, but not because of the U/S) two year old now!

My mom is a sonographer and has been doing ultrasounds for 30 years...I did studies on them in school...while I think it is silly to do unneccessary keepsake (scary) 4D ultrasounds from an untrained technician, I do think the 18-20 week scan for heart, brain, spine, kidneys, stomach and all of that is a technology that I am happy to have. Does that make sense? An ultrasound is simply sound waves that go into the abdomen, bounce off solid structures and report back what they have seen. I tend to think the FDA would post an article like that so that people have to go through their doc and their insurance company will pay the astronomical U/S fee to the doc's office instead of letting the money go to a mall store.

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#19 of 43 Old 08-21-2007, 12:41 PM
 
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its a bit different over here in UK. we get a u/s at 12 weeks to check dates and a scan at 20 weeks for anomoly checks. with the boys i only had those 2 scans with DD i had 1 extra at 16 weeks due to some bleeding and i was fine with tht. with this baby i had my 2 NHS scans and then opted to have a 4D scan. it was nice, but i was wholey disapointed in it to be honest. the pics are good (yet i can totaly under stand the creepy aspect too) it took all of 20 mins which for £200 is a lot of money for a short time.

the guy who did the scan was a registered/licened OB consultant and he did a physical check of baby too which was good to know but in hindsight it was a very expensive 20 min DVD and 24 photos and i dont think ill be doing it again with any future kids i have.

i didnt know there were reasons NOT to have u/s so i think in future ill stick to my 2 NHS scans and be done

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#20 of 43 Old 08-21-2007, 01:06 PM
 
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ultrasounds at $400!!!???wow
here in mexico the visit to the OB is $70 and it includes the u/s.
I had maybe 4, now i did some more research and i know theres no reason to get one every visit(every month)like she wants to. Im feeling theres no reason to go so often, im very healthy, and she just takes my blood pressure and does an u/s.
She does the 4d u/s for $200, but she didnt suggest it to me yet, and if she does, im sooo not doing it!
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#21 of 43 Old 08-21-2007, 01:22 PM
 
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U/S here are at least $400, and that doesn't count the doctor visit or the genetic counseling you might receive afterwards, etc.

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#22 of 43 Old 08-21-2007, 02:20 PM
 
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The u/s tech. here who works with homebirth midwives only costs $150

-Angela
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#23 of 43 Old 08-21-2007, 02:54 PM
 
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I do the 20w u/s myself. However, I know that routine u/s does not improve outcomes. So why do I do it? Peace of mind, I guess. It doesn't really make sense. I would refuse CFM (same deal, does not improve outcomes). It's like I have a hard time believing that having one u/s really doesn't improve outcomes.

I suppose I justify it to myself saying that I'm having a homebirth, which makes it more important that I know things are essentially normal. But I still question the decision to have it, especially when it was very obvious to my that my dd disliked the 20w u/s when she was in utero. Doppler also seemed to bother her.
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#24 of 43 Old 08-21-2007, 03:02 PM
 
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I did the 4D ultrasound to check to see how many babies were in there simply for two reasons: It was $90 and the other was $250 and I didn't want a Dr harassing me afterwards to get a peri since it was multiples.

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#25 of 43 Old 08-21-2007, 03:08 PM
 
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Quote:
Originally Posted by Mommy Kahdib View Post
My cousin had a baby whose intestine was outside of his abdomen. They did a c-section so as not to risk tearing his intestine and there was a crew there ready and waiting to assist him should he have complications. I would just feel more at ease knowing something like this were the case so that he could be taken care of...his intestines had to be covered and kept sterile so that they would not dry out and get infected before they could get him in for surgery. Thankfully he is a happy healthy (albeit crazy, but not because of the U/S) two year old now!

C/sec is no longer recommended for this condition (doesn't improve outcomes) and the treatment until they transfer to a NICU is wrapping the baby's abdomen in seranwrap. Your post actually illustrates well the point that having such info from an u/s increases intervention without improving outcome.
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#26 of 43 Old 08-21-2007, 03:24 PM
 
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That's exactly why I am not having an u/s (the PP about the intestines, the c/s and the outcomes). As seen by a mom on MDC recently who almost lost her son to a near fatal heart defect that wasn't caught on u/s, the c/s not improving outcomes for the intestinal thing, etc..

My midwives and I agree, an u/s might risk me out of a homebirth. I don't want that. I also don't want a false positive to ruin my whole pregnancy.

I feel that most anything that could happen will be easily taken care of at home and we can transfer after the birth. Otherwise, if it's fatal, I can stay home and hold my baby and grieve without having the baby snatched from me, worked on for a while, then being in an uncomfortable hospital gown and bed, sharing my devastation with all the staff and other parents in the ward.

Routine u/s rank up there with vanity ones for me and are not needed if there's no reason to believe you MUST get one.

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#27 of 43 Old 08-25-2007, 02:05 PM
 
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So, Kathryn, what did the tech say after he/she saw three babies? Was it a first for him/ her?
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#28 of 43 Old 08-25-2007, 02:34 PM
 
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Quote:
Originally Posted by blueridgewoman View Post
I think part of the issue with the keepsake u/s places is that their techs aren't trained and licensed, necessarily, the same way that u/s techs at medical facilities are. Personally, my doctor does all my u/s himself, and only for medical need (unfortunately, I have medical need for more due to cervical and uterine issues).
I dont know were you live but in my state the people who perform the u/s (at the keepsake places) are fully licensed and trained, and in fact went to the same schools that the u/s techs at hospitals go to. The reason they work there instead of a hospital is because they pay more. Just because they dont work in a hospital doesnt mean they didnt have the same training.
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#29 of 43 Old 08-25-2007, 04:51 PM
 
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The ACOG recommends that for low-risk pregnancies, women only receive an ultrasound if there is an indication for it -- not as a routine procedure.

Quote:
In the US, the American College of Obstetrics and Gynecology (ACOG) estimates that 60 to 70 percent of pregnant women are scanned, despite an official statement from ACOG that recommends against routine ultrasound.
From http://www.mothering.com/articles/pr...und-risks.html

(This article is six years old, so it is possible that the ACOG has in the meantime changed its position, but I don't know.)

IMO, when you have a mainstream medical group like the ACOG saying "no routine ultrasound," that's a pretty bold statement.

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#30 of 43 Old 08-26-2007, 03:24 AM
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I don't understand why people get all up in arms about a mother going for a medical ultrasound. There are plenty of reasons that mothers do it, albeit small and insignificant to some, enormous to others. Doesn't peace of mind count as something? Furthermore ultrasounds have been done in pregnancies since 1956, so the arguments that I have read stating that they aren't proven to be safe yet shocks me. They have been in use for 51 years, and if they were so horrible why would they still be used?
Anyhow I understand that this thread was about the keepsake ultrasounds, of which I am still on the fence about for myself. Personally they are a little scary to me, but on the other hand if my DH wants it, most likely I'll oblige.

Finally I'm sorry if I've ruffled some feathers, but sometimes I feel like some people are condemned if they make a choice which they feel is important to them by people who have different values. I like to come here for support not to feel that I am a horrible mother because I have been for ultrasounds or that I use a doctor not a midwife and am planning on a hospital birth.

Oh I am completely hormonal and I should step away from my computer.

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