Warning to parents-to-be that non-medical ultrasounds are unapproved, inappropriate, and possibly even risky

May 1 2004

For many expectant parents, ultrasounds offer a window into the world of their growing unborn baby. Unlike most standard prenatal tests that involve nothing more than a urine cup or a needle, ultrasounds present the opportunity to get a sneak preview of what's to come, to actually see what's going on inside - if the heart is beating normally or if the baby registry should be made up of pink or blue.

Despite all of the whimsical notions that ultrasounds hold for many parents-to-be, they're still medical procedures that require a health provider's order. However, a test that was once used solely by medical professionals is now being used by businesses in strip malls and shopping centers to sell keepsake prenatal portraits and videos.

Using technology that allows parents to see high-resolution three- and four-dimensional (moving) images of their baby in the womb, these facilities may employ poorly trained - or even untrained - technicians who aren't given a health provider's order to authorize the procedure and aren't supervised by a physician. The Food and Drug Administration (FDA) and the American Institute of Ultrasound in Medicine (AIUM) warn parents-to-be that these non-medical ultrasounds are unapproved, inappropriate, and possibly even risky.

A common diagnostic procedure, an ultrasound uses high-frequency sound waves to "echo," or bounce, off the body and create a picture of it. A special jelly is applied to the skin on the expectant mother's abdomen, and a wand-like instrument (called a transducer) is positioned over it. Sound waves are generated and reflected back to the transducer as electric impulses, which produce an image of the baby on a computer screen. The images seen on most two-dimensional ultrasounds are difficult for the untrained eye to decipher. What might look like a hand to an expectant parent, might actually be a foot - which is why the images must be interpreted by a properly trained technician. A doctor will then view the report and make his or her own interpretations.

When used as they were to intended be used - in low power levels, for short periods of time by trained professionals such as sonographers, radiologists, and obstetricians - ultrasounds are a standard procedure used to diagnose a pregnancy, determine multiple pregnancies, verify the age of the fetus, detect birth defects and fetal movement, evaluate the position of the placenta, and monitor the baby's growth and heartbeat. Usually performed between 18 and 20 weeks, an ultrasound may be done sooner or later and sometimes more than once.

While it would seem harmless to get an extra ultrasound or two, the long-term effects of repeated ultrasounds on a fetus are still unknown. And facilities offering ultrasounds for the purpose of selling videos or portraits - or finding out the baby's gender - may employ poorly trained, or untrained, technicians who use high power levels for longer periods of time than is deemed safe.

In addition, women getting ultrasounds without a health provider's order may be expecting to hear that that there are no deformities or complications - a diagnosis that an untrained technician can not make. The FDA is also concerned that these non-medical ultrasounds are being misinterpreted as medical examinations and are preventing women from seeking standard prenatal care.

This isn't the first time the FDA has put these non-medical ultrasound businesses in the hot seat - in 2002 the agency warned consumers that anyone administering ultrasounds without a health provider's order was breaking the law.

Although it might be tempting to get baby's first portrait before the little bundle of joy is even born, talk to your obstetrician, nurse-midwife, or family doctor if you're an expectant parent and have questions about ultrasounds. If you've already had a non-medical ultrasound, be sure to follow up with your health  provider.