Tuesday, August 25, 2015

Pregnant Women May Be Getting Unnecessary Ultrasounds

By Kenneth Higby, MD 
Center for Maternal-Fetal Care, an affiliate of MEDNAX, San Antonio 
Consultant, TMA Committee on Maternal and Perinatal Health

Pregnant women are getting more ultrasounds today compared with years past, as The Wall Street Journal reported recently. Last year, American women received an average of 5.2 fetal ultrasounds prior to delivery, up 92 percent from 2004. For most of these women, that’s more than double the number of recommended ultrasounds. 

Two ultrasounds are sufficient for women with low-risk pregnancies: an early one to confirm the gestational age of the fetus — and possibly another scan called a “nuchal translucency evaluation” that assesses the fetus’ risk for certain genetic disorders — and a second ultrasound in the middle trimester to evaluate fetal anatomy and determine gender.

Additional scans in a low-risk patient are unnecessary, though higher-risk pregnancy situations might require more scans.

No objective evidence indicates that obstetrical ultrasound is dangerous to the fetus, but energy is dissipated from the ultrasound beams. Nearly every modern ultrasound machine has energy parameters located on its main screen. These numbers clearly increase when other applications are used, such as pulsed Doppler or color Doppler (techniques used to detect blood flow and fetal heartbeat). When used properly, these should be considered safe procedures for patients. 

It’s important to note that several credentialing organizations for obstetrical ultrasound ensure professionals meet criteria for performing adequate fetal evaluation, in addition to providing guidelines and protocols for patient safety. In the future, medical practices may be required to have certification to perform an obstetrical ultrasound. Such credentialing is important for consistency, performance standards, and patient safety.

TMA recognizes that ultrasound is an important tool for monitoring and assessing the health of the fetus and mother. Earlier this summer, TMA amended its policy to recommend increasing patient and physician awareness on the latest information from the U.S. Food and Drug Administration about the nonmedical use of fetal ultrasound imaging.

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