December 06, 2002

Uverdone ultrasounds

Had an interesting conversation today with a midwife who has been in practice many years. One of her biggest concerns is the overuse of ultrasounds and the de-skilling of midwives and doctors that is resulting from their use. She told me the story of two friends who recently went overdue with their first babies. In both cases the obstetrician ordered another ultrasound “to check that the baby was OK”. The mothers reported that the baby moved around a lot during the procedure and subsequently when they went into a labour soon after, both were found to be malpositioned, resulting in caesarean births for both women.

This midwife feels that the babies may well have been affected by the ultrasound itself, causing them to move into a compromised position. The logic behind this suggestion seems reasonable to me. Another question is also raised by these cases: what were they looking for? Presumably there was concern about reduced liquor, which can be a measure of fetal well-being, but this can be determined by palpating the mother’s abdomen. Of course, with ultrasounds now being used freely this skill will be lost, just as listening to the baby’s heartbeat using a Pinard is a dying art because of the use of sonicaids (more ultrasound!).

Many questions have been raised by concerned consumers regarding ultrasound and very little research is being undertaken. Parents may be concerned to limit ultrasound exposure as a result of some studies, but avoiding it altogether is becoming more difficult. Parents don’t always realise that the doctor’s (or midwife’s) sonic aid, the CTG ordered during pregnancy and the electronic fetal monitoring used during labour all use ultrasound to obtain the necessary data. Following the guidelines to limit ultrasound exposure during pregnancy is usually interpreted as avoiding more than one scan, when in fact the baby may be exposed to much greater levels of ultrasound, and for longer periods of time, through use of these other technologies. Keeping baby safe during pregnancy (which of course means the labour as well) just gets harder and harder for the diligent mother.......

Posted by andrea at December 06, 2002 02:56 PM

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