Articles on U/S safety (for those that want to research)

669 Views 20 Replies 10 Participants Last post by shantiani, Dec 7, 2008

DahliaRW

Discussion Starter · Dec 6, 2008

http://www.midwiferytoday.com/articl...oundwagner.asp

This one quotes the WHO's stance on u/s, and two studies, one which found that:

Quote:

The second landmark paper, also a randomized controlled trial, looked at the safety of repeated prenatal ultrasound imaging. While the original purpose of the trial was hopefully to demonstrate the safety of repeated scanning, the results were the opposite. From 2,834 pregnant women, 1,415 received ultrasound imaging at 18, 24, 28, 34 and 38 weeks gestation (intensive group) while the other 1,419 received single ultrasound imaging at 18 weeks (regular group). The only difference between the two groups was significantly higher (one-third more) intrauterine growth retardation in the intensive group.

But, it is important to note that these woman received 5 u/s, not just one or two. I would guess ome of the IUGR had to do with the frequent exposure.

Here is one from mothering: http://www.mothering.com/articles/pr...und-risks.html

http://www.bio-medicine.org/medicine...tioned-3092-1/

This one says that fetal growth is affected by repeated u/s, but that the children's growth does normalize.

http://prenatal-health.suite101.com/...rasound_safety

Quote:

Further complicating the issue is that power levels for diagnostic ultrasound machines have increased eight-fold since the early 1990s. Studies of the effects of prenatal ultrasound prior to that date may therefore no longer be valid. Some scientists have speculated that the fetal brain may be especially vulnerable to damaging effects during periods of rapid growth and migration of neurons.

http://www.isrrt.org/images/isrrt/11...ESSION%202.pdf

Quote:

If subliminal changes are happening at
the increased intensity levels currently
being used the effects may not become
apparent for another 20 to 30 years.
Cautious and prudent use of ultrasound
is therefore advised.

(bolding mine)

http://www.fetalultrasoundsafety.net/ has a TON of articles.

I think the main thing to keep in mind is that u/s, like vaccines, have had no LONG TERM studies to prove their safety. So you need to weigh the pros and cons to having u/s and decide for yourself. It does seem that having LOTS of u/s could be more harmful than just having one or two, and that is important to keep in mind as well.

I also have a good article somewhere about how they think that u/s might affect eyesight in children, but it hasn't been proven. Something about how the eye cells are more succeptible to heat. But I can't find the link right now. I'll see if I can find it later.

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1 - 20 of 21 Posts

mamaveggie

· #2 · Dec 6, 2008

Thanks for doing the research.

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AnnR33

· #3 · Dec 6, 2008

Thanks, this is great information.

The more info a person can have the more informed a decision they can make.

MOMYS

· #4 · Dec 6, 2008

Thank you!

shantiani

· #5 · Dec 6, 2008

Thank you for that. There are a couple I hadn't seen before.

MadameXCupcake

· #6 · Dec 6, 2008

Awesome!
I had alreadu planned on one or none next pregnancy but its awesome seeing some research!

And power has increased eight-fold???

:

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mrsbabycakes

· #7 · Dec 6, 2008

Thank you for posting information. I'm always receptive to more knowledge!

mrsbabycakes

· #8 · Dec 6, 2008

I've been reading these and have found them to be a reasonable roundup of advice. I've also been trolling around on PubMed (medical research database) and found that the main indication for significant thermal effects on fetuses is maternal fever and prolonged use.

I found the http://www.fetalultrasoundsafety.net/ to be interesting, but not very practical in terms of patient information. It poses more musing questions than arguments, at least from what I read. I'd like to see more helpful information for those patients interested in u/s but wanting a lower MI.

"If subliminal changes are happening at
the increased intensity levels currently
being used the effects may not become
apparent for another 20 to 30 years.
Cautious and prudent use of ultrasound
is therefore advised. "

Your quoted bit (above) came from a powerpoint slide, not a research article, just to clarify. It appears to be the opinion of the person presenting the slideshow, though it's unclear. Do you happen to know if it came from a research article?

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DahliaRW

Discussion Starter · #9 · Dec 6, 2008

The powerpoint show was given by a member of the "International Society of Radiographers and Radiological Technologists" (http://www.isrrt.org/isrrt/Default_EN.asp) so while it is opinion, it is expert opinion, kwim? I'm sure I could find the articles the presentation was based on if I had the time.

Carlin

· #10 · Dec 6, 2008

Interesting, and thank you. I'm particularly appreciative that some of the articles actually cite their sources

I'll get a chance to take a look at some of the original articles when I have access to our library database at work next week.
I think I've spent enough time crashing your ddc tonight. Thanks for the discussion!

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mrsbabycakes

· #11 · Dec 6, 2008

Quote:

Originally Posted by DahliaRW

View Post

The powerpoint show was given by a member of the "International Society of Radiographers and Radiological Technologists" (http://www.isrrt.org/isrrt/Default_EN.asp) so while it is opinion, it is expert opinion, kwim? I'm sure I could find the articles the presentation was based on if I had the time.

Well, they are listed at the end of the slideshow. While I appreciate expert opinion, I'd like to see what it is based on. Usually in published research (and I'm sure during her presentation) the reasoning is offered for opinions like that.

It's a shame that one BioMedicine article doesn't link to the actual source research. You haven't seen the original research article, have you?

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alicewyf

· #12 · Dec 6, 2008

Thanks for these. This cements my decision to have no (or as few as possible) ultrasounds.

shantiani

· #13 · Dec 6, 2008

Quote:

Originally Posted by mrsbabycakes

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It's a shame that one BioMedicine article doesn't link to the actual source research. You haven't seen the original research article, have you?

I haven't read this yet, but I'm pretty sure this is the paper they were referencing:
Newnham JP, Doherty DA, Kendall GE, Zubrick SR, Landau LL, Stanley FJ. Effects of repeated prenatal ultrasound examinations on childhood outcome up to 8 years of age: follow-up of a randomised controlled trial. Lancet 2004;364:2038-44.

I'm not able to add attachments, so I can't attach the pdf. You'll need pubmed or something to open it.

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Quindin

· #14 · Dec 6, 2008

I am not too keen on ultrasounds, but because I had a missed miscarriage once and had complications because of it (baby died but I only found out 4 weeks later) I now say "yes please" to the nuchal US on the first trimester. And yes, I also want to know if the baby has major issues, so I go for the 20 week US too

My MIL loves to say how horribly I am damaging my babies for having those 2 US, but I think it is important to do one's research and balance the risk vs the benefits. For example, if I am expecting twins again, I think that the benefits of monitoring their growth far outweigh the risks ( I lost twins due to TTTS )

mrsbabycakes

· #15 · Dec 6, 2008

Quote:

Originally Posted by shantiani

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I haven't read this yet, but I'm pretty sure this is the paper they were referencing:
Newnham JP, Doherty DA, Kendall GE, Zubrick SR, Landau LL, Stanley FJ. Effects of repeated prenatal ultrasound examinations on childhood outcome up to 8 years of age: follow-up of a randomised controlled trial. Lancet 2004;364:2038-44.

I'm not able to add attachments, so I can't attach the pdf. You'll need pubmed or something to open it.

Excellent!!! Thank you. I have access to pubmed.

This is the publication that followed the group of children with a higher rate of IUGR following multiple scans, the publication cited in the midwiferytoday article. Newnham, J. et al. (1993). Effects of frequent ultrasound during pregnancy: A randomised controlled trial. Lancet.

These quotes are from the article:

Quote:

The overall absence of any deleterious effects of prenatal scans on childhood development is consistent with results from other studies, although previous investigations were not based on the use of multiple scans.In our study, the only significant difference in developmental outcomes in the group that had received multiple scans was a reduction in the proportion of infants at 1 year of age with abnormal scores on the ELM scale. This instrument provides an assessment of speech and language delay. At later ages, all tests of this aspect of development were similar in the two groups. The many end-points tested in this study render it likely that this single significant finding resulted from chance. There is no evidence from our results of any adverse developmental outcomes from multiple prenatal ultrasound exposures.

Quote:

Our results also provide reassurance that multiple prenatal ultrasound scans are not followed by smaller body size in infancy or childhood.

Quote:

It would, however, be incorrect to conclude from our present findings that multiple prenatal ultrasound scans influence growth before birth. The original purpose of our randomised controlled trial was to investigate the hypothesis that a protocol of multiple scans would improve pregnancy outcome and reduce the rate of preterm birth. The original study therefore did not prove that prenatal ultrasound scans affect fetal growth, but has provided evidence that further study is warranted. These results from the childhood follow-up confirm that even if ultrasound scans affected growth before birth, weight, height, circumferences, and skin-fold thicknesses from 1-8 years are unaffected.

Quote:

Reassurances provided by our results do not lessen our need to undertake further studies of potential bio-effects of prenatal ultrasound scans. The children in this study seem to be the only published cohort from a randomised controlled trial in which a protocol of multiple ultrasound imaging and Doppler flow studies was compared with a single imaging scan and in which ascertainment of gestational age in the two groups has been identical.

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shantiani

· #16 · Dec 7, 2008

DahliaRW, do you (or anyone else) have any info on doppler? I doubt I'll need another u/s, but I know the doppler choice is going to come up at every visit. I was so looking forward to hearing that HB, but all of my attention was really focused on the uncertainty of u/s, not doppler. So (sigh).... now I'm torn. I would love to read some data to help me decide.
I'll search around on my own too, but since my thesis is due by the end of the week (

) I probably won't get very far soon!
Thanks!

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DahliaRW

Discussion Starter · #17 · Dec 7, 2008

Quote:

Originally Posted by shantiani

View Post

DahliaRW, do you (or anyone else) have any info on doppler? I doubt I'll need another u/s, but I know the doppler choice is going to come up at every visit. I was so looking forward to hearing that HB, but all of my attention was really focused on the uncertainty of u/s, not doppler. So (sigh).... now I'm torn. I would love to read some data to help me decide.
I'll search around on my own too, but since my thesis is due by the end of the week (

) I probably won't get very far soon!
Thanks!

I couldn't find any info on doppler safety other than the sites that rent them out that all say they are safe (but I would conclude those sites are obviously biased). I wish I still had access to the med library at the UW. Sigh!

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shantiani

· #18 · Dec 7, 2008

Yeah, those doppler rental websites are useless for information.
I have access to the med library at the UW though... My lab is in the health sciences building!
I notice you live near the Cascades... are you in Seattle? (I live in Ballard. I'll be a UW grad student for one more week

)

Well, I'll try to get this %^&* paper done soon I can scour pubmed and the library before my MW appt next Monday.

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DahliaRW

Discussion Starter · #19 · Dec 7, 2008

Quote:

Originally Posted by shantiani

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Yeah, those doppler rental websites are useless for information.
I have access to the med library at the UW though... My lab is in the health sciences building!
I notice you live near the Cascades... are you in Seattle? (I live in Ballard. I'll be a UW grad student for one more week

)

Well, I'll try to get this %^&* paper done soon I can scour pubmed and the library before my MW appt next Monday.

Yup, I'm on the eastside! When I was a grad student there (when I was pregnant with my first ironically) I could access the med library. It was awesome! Not that I'd actually have time to go there with two littles, LOL!

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mrsbabycakes

· #20 · Dec 7, 2008

Quote:

Originally Posted by shantiani

View Post

Yeah, those doppler rental websites are useless for information.
I have access to the med library at the UW though... My lab is in the health sciences building!
I notice you live near the Cascades... are you in Seattle? (I live in Ballard. I'll be a UW grad student for one more week

)

Well, I'll try to get this %^&* paper done soon I can scour pubmed and the library before my MW appt next Monday.

You don't have VPN access through the library website? I'm an undergrad and I have full pubmed access from home at my institution.

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