Safety Concerns Over Use of Commercial Ultrasound Scans

Soon-to-be parents' desire to see images of their unborn children has given rise to commercial companies offering keepsake ultrasound scans without medical supervision, frequently referred to as "boutique ultrasonography.” With the appearance of this new phenomenon, national agencies are addressing their concerns over safety issues of mass commercialization of this imaging technique.

In a special report in the February 3, 2007, issue of the British Medical Journal, journalist Geoff Watts debated whether this non-medical use of the technique can be justified. Improvements in ultrasound technology have transformed antenatal scans from two-dimensional (2D) black and white images to 3D, 4D, and even moving images of the unborn child. Expectant parents seeking a CD-ROM or a DVD of their scan can expect to pay US$300-490.

The companies that manufacture ultrasound scanners state that ultrasound has not been shown to cause any harm to mother or infants; however, the U.S. Food and Drug Administration (FDA), the American Institute of Ultrasound in Medicine, and the French Academy of Medicine are among several official institutions that have reservations about such use of the technology. The British Medical Ultrasound Society does not have a specific policy on non-medical imaging, but is currently updating its guidance.

The FDA reported, "Although there is no evidence that these physical effects can harm the fetus, public health experts, clinicians, and industry agree that casual exposure to ultrasound, especially during pregnancy, should be avoided.”

There are also concerns about how the staff deals with the finding of a fetal abnormality. Various clinicians offer keepsake images after they have performed ultrasound for medical reasons. The FDA takes a muted view of this, but the American Institute of Ultrasound Medicine deems it to be consistent with their ethical principles.

Beyond spreading a little joy, the case for non-medical imaging relies chiefly on bonding: the sense of attachment between a mother and her unborn child, according to Mr. Watts. The evidence that ultrasound images can enhance this comes from 2D scans, but there is no evidence that 3D scans are more effective in enhancing maternal-fetal attachment.

The controversy over 3D and 4D imaging would be somewhat resolved if a real medical benefit could be shown, Mr. Dr. Watts added. Studies are currently under way to determine if seeing the fetus in 3D might help identify abnormalities such as cleft lip. Early indications are that it may be useful but, for now, it appears that this new trend is not self-evidently beneficial.