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Are 4-D Ultrasounds a Good Idea?

Katlyn Joy |14, May 2013


Since the 1950s ultrasounds have given medical professionals and parents a glimpse into the womb not to mention baby's first portrait. Since then, we've come a long way with technology advancing into 3-D images and the even newer 4-D views.

How Does Ultrasound Work in Pregnancy?

When an ultrasound is performed the pregnant woman will often be asked to drink a certain amount of liquid and avoid urinating so the bladder is full. Two different types of ultrasound methods are used. Transvaginal uses a wand that is inserted into the vagina where transabdominal uses a transducer on the abdomen.

The transducer is a small plastic wand that emits and receives sound waves. A gel is placed on the woman's belly to reduce air between the skin and the transducer and help conduct the sound waves. Those sound waves create a grainy black and white image in traditional or 2-D ultrasound technology which can be difficult for untrained eyes to discern.

How are 3-D and 4-D Ultrasounds Different than 2-D?

With the newer methods a 3-D photo quality image is obtained by getting deeper in-depth scans. The next level or 4-D is when the still images of a 3-D scan are rapidly displayed giving a video or motion-enhanced portrait of the baby.

Benefits of 3-D and 4-D Ultrasounds

- Doctors can gain valuable information by viewing how a fetus moves in the womb, particularly when looking for abnormalities such as Down Syndrome.

- The enhanced ultrasounds can better determine fetal weight.

- In up to 70 percent of cases where abnormalities were present, 3-D scans provided more detailed information.

- 3-D scans can identify with much better accuracy women who are at risk for pre-term delivery by better viewing cervical length, a determining factor in such births a significant amount of the time.

- The enhanced images of 3 and 4-D ultrasounds can pick up a number of problems with the pregnancy and baby such as uterine abnormalities, placental abnormalities and placement, uterine bleeding, presence of tumors or fibroids and organ development.

Concerns About 3-D and 4-D Ultrasounds

Some studies have raised questions whether repeated scans may cause inter-uterine growth disorder. Others have noted a higher incidence of hearing problems and left-handedness with scans. A 2001 and a 2005 study found that when pulses were pointed at baby's head, the fetus responded. This has not been studied in depth yet however to determine what this may mean, such as does it cause an unborn infant discomfort or distress.

The American College of Obstetricians and Gynecologists issued a statement in 2005 which was re-affirmed in 2012 that warned against the practice of non-medical ultrasounds.

"Nonmedical ultrasonography may falsely reassure women. Even though centers that perform nonmedical ultrasonography and create keepsake photographs and videos of the fetus may offer disclaimers about the limitations of their product, customers may interpret an aesthetically pleasing image or entertaining video as evidence of fetal health and appropriate development. Ultrasonography performed for psychosocial or entertainment purposes may be limited by the extent and duration of the examination, the training of those acquiring the images, and the quality control in place at the ultrasound facility. Women may incorrectly believe that the limited scan is, in fact, diagnostic.

Abnormalities may be detected in settings that are not prepared to discuss and provide follow-up for concerning findings. Without the ready availability of appropriate prenatal health care professionals, customers at sites for nonmedical ultrasonography may be left without necessary support, information, and follow-up for concerning findings."

The American Institute of Ultrasound in Medicine, or AIUM, issued their statement on keepsake fetal imaging in April 2012. Keepsake fetal imaging are 3-D and 4-D scans performed by commercial rather than medical facilities to give parents photos and videos of their unborn child. According to the AIUM,

"The AIUM recommends that appropriately trained and credentialed medical professionals (licensed physicians, registered sonographers, or sonography registry candidates) who have received specialized training in fetal imaging perform all fetal ultrasound scans. These individuals have been trained to recognize medically important conditions, such as congenital anomalies, artifacts associated with ultrasound scanning that may mimic pathology, and techniques to avoid ultrasound exposure beyond what is considered safe for the fetus. Any other use of "limited medical ultrasound" may constitute practice of medicine without a license. The AIUM reemphasizes that all imaging requires proper documentation and a final report for the patient medical record signed by a physician.

Although the general use of ultrasound for medical diagnosis is considered safe, ultrasound energy has the potential to produce biological effects. Ultrasound bioeffects may result from scanning for a prolonged period, inappropriate use of color or pulsed Doppler ultrasound without a medical indication, or excessive thermal or mechanical index settings. The AIUM encourages patients to make sure that practitioners using ultrasound have received specific training in fetal imaging to ensure the best possible results."

Parents should heed the advice of medical professionals to avoid any potential harm to baby, and avoid unnecessary medical procedures. Most pregnancies will require at least a couple ultrasounds and to get additional ones for bonding or the sake of photos seems imprudent even if research has yet to show real dangers. The truth is there is much we don't yet know and unnecessary risk is just that, unnecessary.

Sources: American College of Obstetrics and Gynecology, Mayo Clinic Foundation, American Institute of Ultrasound in Medicine

Katlyn Joy is a mother to 7 children, and a freelance writer. She earned her Master of Arts in Creative Writing and Poetry, and a Bachelor of Arts in English and was previously an adviser to new mothers on breastfeeding through a maternity home program. She currently resides in Colorado with her family.

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