Keepsake Ultrasounds: Risk vs. Benefit

by Dr. Gerard M. DiLeo

If you're an expecting parent, you've likely seen the prenatal imaging "boutiques" that have sprouted up across the country. These businesses, sometimes working with physicians or medical facilities, perform a "keepsake ultrasound" for the expecting couple—a 3D or 4D record of an unborn child, allowing the parents-to-be to view their little one with amazing clarity. Sound intriguing? Maybe you've wondered about the safety of these shops—so let's examine the risks and benefits, and whether one outweighs the other.

The truth is, all of us are irradiated daily. Microwaves, infrared, FM, AM, VHF, and UHF are all around us—and through us—daily. No one, not even pregnant women, fears walking through metal detectors at airports. In today's world, fearing radiation without proof of harm is no more reasonable than the primitive thinking that taking a photograph steals the soul.

Enter ultrasound.

Not a recent development, ultrasound technology actually hit the medical scene about thirty years ago, and in obstetrics has been the target of every accusation from congenital absence of limbs to autism. The biggest thing going for the safety of ultrasound is that it's been around for so long. When the FDA determines that a medicine is safe based on studies that involve a few thousand people, it is sometimes surprised by the outcomes of the bigger "studies" that result when the general public, in the hundreds of thousands, begins using a product in the marketplace. Something that may not show up in thousands of people can show up in hundreds of thousands, explaining recalls of medications such as Vioxx and Bextra. Yet ultrasound, having been around for so long, has now passed even the bigger "study" of the marketplace. And the 3D and 4D ultrasound for keepsake imaging of the unborn baby has reached that milestone as well. Certainly time is on the side of such ultrasound from a safety standpoint.

Ultrasound, like any medical procedure, is a prescription item—to be performed only under the direction or order of a licensed physician. So technically, unless one were to stroll into a keepsake ultrasound boutique with a prescription for the ultrasound, having a keepsake done is illegal. So far, it's been a "don't ask—don't tell" offense with state licensing boards, but that likely won't last when alarmists begin making official written complaints about it to the respective boards. By policy, these boards have to act on any written complaints, and if the traffic of grievances becomes burdensome enough, they will act to relieve themselves of administrative red tape. One decree can free them of many investigations—it's all a matter of critical mass at the bureaucratic level.

Even if a pregnant woman is armed with a handy prescription, she must remember that the ultrasound is only as good as the person wielding the ultrasound head. Medically, ultrasound technology is sophisticated and a legitimate part of the subspecialty of radiology—yet anyone with enough money can buy an ultrasound machine and turn it on. Thus arises the fear of missing abnormalities or perhaps seeing something wrong that really isn't wrong, alarming a woman to seek unnecessary testing. This is a questionable issue in keepsake ultrasound.

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