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Is
ultrasound safe ... or worth it?
Although women are now routinely offered several ultrasound scans
during a pregnancy, costing health services worldwide millions
of pounds every year, its safety has never been tested. This assumption
of safety has led to:
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researchers who are studying foetal behaviour reassuring
women volunteering to take part in their trials that exposures
of up to an hour and a half are safe
-
commercial companies offering parents lengthy ‘videos’
of their baby moving inside the womb. (The US Food and Drink
Administration (FDA) warns that ultrasound cannot be considered
harmless, even at low levels, and is considering regulatory
action against these companies)
-
companies being granted safety licenses to offer parents-
to-be hand-held Doppler ultrasound devices with which, theoretically,
they could expose their babies to hours of ultrasound every
day
Several trials suggest that Governments should be more concerned,
e.g.:
-
When women at risk of giving birth preterm were examined
once a week to determine the state of their cervix, just
over half (52%) of those who were examined using ultrasound
went on to have a preterm birth compared to a quarter (25%)
of those given a manual pelvic examination.
Ultrasound scanning gave no benefit over manual examination
[1]
-
When 1,246 UK women were given a monthly Doppler ultrasound
scan of their umbilical and uterine arteries from the 19th
to the 32nd week of pregnancy, seventeen of their babies
died at or around the time of birth, as opposed to only
seven in the 1,229-strong unDopplered control group. The
Doppler scanning had only identified a possible problem
in one of the babies [2]
Ed.- (i) AIMS Journal’s Jean Robinson is concerned
that no research has ever been done on the effects of:
-
exposing even younger foetuses to ultrasound, an increasingly
common practice
-
submitting foetuses to exposures of an hour or more, as
in the commercial applications described above
She also points out that:
-
because ultrasound is now almost universally used, it has
become almost impossible to assemble a control group of
completely unexposed children. Only degrees of exposure
can now be compared
-
the claim that ultrasound encourages bonding between mother
and child has also never been demonstrated scientifically
(ii) Other studies, however, suggest that ultrasound is more
efficient than manual pelvic examination at detecting major
malformations and twins early. [3]
[1] Lorenz,RP et al. American Journal
of Obstetric Gynaecology 1990;162(6):1603-607
[2] Davies,JL et al. Lancet 1992;ii:1299-303
[3] Saari-Kemppainen,A et al. Lancet 1990;336(8712):387-91
(11453) Beverley Beech. AIMS Journal
Yes,
just looking can hurt
Having one or more ultrasound scan to see your baby in
the womb has become almost the norm. Although there has
never been any significant research to prove it, the practice
is assumed totally safe by doctors and parents-to-be alike.
In fact, the opposite is true.
Three randomised controlled trials of Doppler Sound,
the powerful form of ultrasound now used in most hospitals,
have found an up to fourfold increase in perinatal (just
before or after birth) deaths. [1]
One large study found 20 miscarriages in the group given
ultrasound scans, but none in the group which was not.
[2] Another reported a doubling
of pre-term labour in the scanned group. [3]
Another linked ultrasound scanning to retardation of the
baby's growth in the womb. [4]
Animal-based studies suggest that there may be subtler
effects which have, to date, not been measured in humans.
Monkeys repeatedly exposed to ultrasound showed clear
behavioural problems, such as social withdrawal. Another
study using monkeys found evidence of low body weight
and poor muscle tone.
Experiments with guinea pigs showed that it could raise
the temperature of brain tissue near bone by as much as
5.1°C. [5] If the same
occurs in human babies at the time the developing brain
is at its most vulnerable (16 weeks old, when ultrasound
scanning tends to be carried out), it is possible that
vital cells could be damaged or destroyed with little
possibility of replacement. This could lead to long-term
neurological damage. [6]
Changes in brain development sometimes lead to lefthandedness.
[7] Not a problem in itself,
but lefthandedness is linked to an increased risk of dyslexia,
[8] learning difficulties
[9] and speech delay.
[10]
The argument for ultrasound scanning revolves around
its ability to detect abnormalities early enough to abort.
Firstly, several studies have shown that ultrasound does
not improve outcomes for babies overall, and that there
is no medical reason to propose a scan in 80% of cases.
Secondly, ultrasound can only detect a handful of the
5000+ potential chromosomal abnormalities. It is most
successful at detecting Down's syndrome, picking up 80%
of cases, but even here can diagnose Down's syndrome when
it isn't actually present. Scanning can pick up `things
that shouldn't be there' - resulting, again, in the abortion
of healthy foetuses - when that `thing' often disappears
during the pregnancy. Parents who decide not to abort
are put through months of unnecessary worry. In one instance
at a hospital in Cardiff (Wales), scans detected `dead'
babies which were subsequently found to be alive just
before the induced miscarriage was to be performed.
Finally, scans can pick up abnormalities about which
nothing can be done.
[1] Lancet
1992;340:1229-303
[2] Lancet 1990;336:387-91
[3] American Journal of Obstetric Gynaecology 1990;162:1603-10
[4] Lancet 1993;342:887-91
[5] Horder,MM et al. Ultrasound in Medicine & Biology
1998;24(5):697-704
[6] Birth 1986;13:29-37
[7] Kieler,H et al. Epidemiology 2001;12(6):618-23
[8] Obstetrics & Gynaecology 1984;63:194-200
[9] Neurotox. Teratol. 1995;17:179-88
[10] Canadian Med. Assoc. Jnl. 1993;14 9:1435-40
(6698) Pat Thomas. Natural Parent 1.5.00 p26
Left
handedness in ultrasound babies
New research suggests that ultrasound tests may affect babies’
brains. Looking back at 2161 babies born 1979-81 Norwegian researchers
found that those who had been exposed to ultrasound were 30% more
likely to be left-handed. This could have happened by chance but
they believe it may indicate “a sensitive index of subtle
changes in the development of the brain”.
(5135) Salvesen,KA et al. British Medical
Journal 1993;307(6897):159-64
Ultrasound scans linked to brain damage
in babies
A third study has linked lefthandedness to ultrasound scanning,
suggesting that it has caused genetic damage in the brain. In
this case 7000 men whose mothers had ultrasound scans in the ’70s
were compared to 170,000 men whose mothers did not. There was
a significant increased rate of lefthandedness in the 7,000 men
who had been scanned when in the womb and, critically, an even
higher increase in those born after 1975, when doctors introduced
a routine second scan. Lefthandedness is linked to an increased
risk of a range of conditions, e.g.learning difficulties, dyslexia
and epilepsy. The study was conducted on men because male babies’
brains continue to develop later than female babies’ brains,
making them more susceptible to damage from external factors.
In Britain, lefthanded people now form 11% of the population,
compared to just 5% in the 1920s. The researchers have estimated
that only a fifth of this doubling can be accounted for by a relaxation
on the old practice of suppressing lefthandedness.
(8663) Kieler,H et al. Epidemiology 2001;12(6):618-23
Courtesy of Robert Matthews. Sunday Telegraph 9.12.2001
No link with childhood
leukaemia
A large case-controlled study from Sweden was
unable to show any link between the use of ultrasound examination
of babies in the womb and childhood leukaemia. In the preamble
to the research description, however, the authors remind us that
other studies have shown that ultrasound can cause membrane changes
which might affect the embryo’s development as well as postnatal
development, and that ultrasound has been associated with lefthandedness.
(6146) Naumburg,E et al.
British Medical Journal 29.1.00 p282
Ultrasound - small babies catch up
In 1993 Australian research [1]
found some evidence that foetuses exposed to five sessions of
ultrasound imaging and continuous-wave Doppler flow studies between
the eighteenth and thirty-eighth week of pregnancy tended to be
born smaller and shorter than babies given a single ultrasound
scan in the eighteenth week.
Some good news
The team followed the babies’ progress for the next eight
years. By the time the babies were a year old, there were no significant
differences in size. When the children underwent standard tests
of childhood speech, language, behaviour and neurological development
at ages two, three, five and eight, it suggested that the children’s
neurological development had been normal as well.
Ed.- (i) These findings come as a relief, but the fact that the
repeated ultrasound or Doppler scans reduced the foetus’
growth is still cause for alarm. Doppler scans are not the same
as ultrasound scans. They are used to measure blood flow in the
foetus’s arteries and expose the foetus to larger doses
of ultrasound.
AIMS Journal’s Jean Robinson commented as follows:
The Doppler and ultrasound imaging machines used in the original
1993 trial were weaker than those used these days. No research
on the safety of today’s machinery has been carried out
The researchers are still concerned by the apparent link between
boy’s exposure to ultrasound and an increased likelihood
of being left-handed.{2] They intended
to examine this issue when the children were ten
[1] Newnham,JP et al. Lancet 1993;342:887-91
[2] Salvesen,KA and Eik-Ness,SH. Ultrasound Obstetrical Gynaecology
1999;13:241-46
(11454) Newnham,JP et al. Lancet 2004;364(9450):2038-44
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