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...we conducted a systematic review and meta-analysis to evaluate the safety of human exposure to ultrasonography in pregnancy.
A systematic search of electronic databases, reference lists and unpublished literature was conducted for trials and observational studies that assessed short- and long-term effects of exposure to ultrasonography, involving women and their fetuses exposed to ultrasonography, using B-mode or Doppler sonography during any period of pregnancy, for any number of times. The outcome measures were: (1) adverse maternal outcome; (2) adverse perinatal outcome; (3) abnormal childhood growth and neurological development; (4) non-right handedness; (5) childhood malignancy; and (6) intellectual performance and mental disease.
The electronic search identified 6716 citations, and 19 were identified from secondary sources. A total of 61 publications reporting data from 41 different studies were included: 16 controlled trials, 13 cohort and 12 case-control studies. Ultrasonography in pregnancy was not associated with adverse maternal or perinatal outcome, impaired physical or neurological development, increased risk for malignancy in childhood, subnormal intellectual performance or mental diseases. According to the available clinical trials, there was a weak association between exposure to ultrasonography and non-right handedness in boys (odds ratio 1.26; 95% CI, 1.03-1.54).
According to the available evidence, exposure to diagnostic ultrasonography during pregnancy appears to be safe.
Ultrasound has an extraordinary safety record. It has been used in obstetrics for almost four decades with no proven harmful effects. In this issue of the Journal there is an updated review of the epidemiological literature. The authors conclude that exposure to diagnostic ultrasound during pregnancy appears to be safe. So why is safety of ultrasound an issue; or is it an issue?
• We do not know that modern ultrasound devices are safe
• Ultrasound operators do not know how to use the real-time display of safety information on the screen
• Doppler is used in the first trimester in normal pregnancies
• Journal policy on publishing reports of first-trimester Doppler ultrasound research is not followed
• There is a possible link between experimental and epidemiological evidence on ultrasound and handedness
• Is ‘souvenir scanning’ a problem for the future of ultrasound?
• Where do we go from here?
There is no such thing as zero risk, and absence of evidence of harm is not equivalent to evidence of absence of harm. More research is welcomed, but the time has passed when randomized controlled trials with ‘ultrasound free’ control arms could be done. As professionals involved in ultrasound, we must regulate ourselves sensibly—or else someone else is likely to. We owe it to our patients, to unborn babies and to the future of ultrasound.
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Becky wrote: We have just recently found out that we will be the proud grandparents of a brand new baby boy in September. Congrats Kelly and Josh
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hvgal, I appreciate you sharing an alternative point of view as well, and I'm not one to just automatically pooh-pooh unconventional points of view, as the basis of new ideas often starts as notions that are scoffed at. However, I also do not accept only opinions/anecdotal evidence on a claim - there must be credible, independent, duplicated double-blind placebo controlled studies showing evidence of said claim. So the papers that I cited are posted on government sites because the funding for them came from the government, but the research is from independent scientists. Thousands of them, from around the world. Scientists are not the manufacturers of the machines, nor profiting off of their use - they have no financial stake in "pushing" ultrasounds (and, indeed, do not - they aren't recommended unless medically necessary) to question their results and policies set forth to date, and they are always reviewing new concerns - how do you see a conspiracy in there?hvgal wrote: Science chic, while I appreciate you sharing an alternative view point I must say that if you seach on government websites you will only find out what the government wants you to know. In this case, they definately don't want you to know that they have known for years the harmful effects of ultrasound. When it was originally introduced Japan refused to use it because it was found to cause chromosonal damage. Now we are seeing the babies of those first ultrasound bablies and the insidence of "disease" related to chromosonal damage is skyrocketing. A coincidence? I think not. If you Google (or whatever search engine you use) ultrasound and safety or autism you will find much more information. Sadly and especially when it comes to women's health, the government is not who you want to rely upon.
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