Ultrasound Vs. Birth Defects

While pregnant with Zekie I started to hear rumblings of a link between ultrasounds and autism. But when I began to research it a little bit more, I found research studies were suggesting ultrasounds might not only be related to the rise in autism, but in other birth defects as well. Have you heard this before? Yeah, doubtful your doctor brought it up, probably not because she was trying to hide something, but more likely she doesn’t know either. Here are some excerpts that I found especially interesting and the links to the full articles are listed below if you would like more information.

“As the FDA warned in 2004, “ultrasound is a form of energy, and even at low levels, laboratory studies have shown it can produce physical effect in tissue, such as jarring vibrations and a rise in temperature.”(9) This is consistent with research conducted in 2001 in which an ultrasound transducer aimed directly at a miniature hydrophone placed in a woman’s uterus recorded sound “as loud as a subway train coming into the station.”(10)” – (1)

This statement supports what Jeremy and I had already suspected based off the movements of Kingston during his 19 week ultrasound. He moved away from where the wand was placed and would even cross his arms in front of his face which gave us the impression he was aware of the ultrasound happening and not particularly happy about it.

“The idea that a prenatal ultrasound can be hazardous is not new. The previously mentioned 1982 WHO report, in its summary “Effects of Ultrasound on Biological Systems,” stated that “…animal studies suggest that neurological, behavioral, developmental, immunological, haematological changes and reduced fetal weight can result from exposure to ultrasound.”(25)”

Two years later, when the National Institutes of Health (NIH) held a conference assessing ultrasound risks, it reported that when birth defects occurred, the acoustic output was usually high enough to cause considerable heat.(26). Although the NIH has since stated that the report “is no longer viewed…as guidance for current medical practice,” the facts remain unchanged.

Despite the findings of these two major scientific gatherings, in 1993 the FDA approved an eight-fold increase in the potential acoustical output of ultrasound equipment (27), greatly increasing the possibility of disastrous pregnancy outcomes caused by overheating. Can the fact that this increase in potential thermal effects happened during the same period of time the incidence of autism increased nearly 60-fold be merely coincidental?” – (1)

“Despite long-standing evidence that ultrasound induces thermal effects and that thermal effects can harm fetal brain development, the cause of autism has remained so elusive to researchers that many autism societies use a puzzle piece as part of their logos. Particularly confounding is the fact that ASD plagues the children of high-income, well-educated families who have the best obstetrical care money can buy. Why would women who took their prenatal vitamins, observed healthy diets, refrained from smoking or drinking and attended all regularly scheduled prenatal visits bear children with profound neurologically based problems?”(1)

“What all industrial countries do have in common is the quiet yet pervasive change in obstetrical care: All of them use routine prenatal ultrasound on pregnant women.

In countries with nationalized healthcare, where virtually all pregnant women are exposed to ultrasound, the autism rates are even higher than in the US, where due to disparities in income and health insurance, some 30 percent of pregnant women do not yet undergo ultrasound scanning.” – (1)

“One of the most popular non-medical uses of ultrasound, which can extend a medically indicated session, is to determine the sex of the baby. Could this have a connection to the increase in birth defects involving the genitals and urinary tract? The March of Dimes says that these types of birth defects affect “as many as 1 in 10 babies,” adding that “specific causes of most of these conditions is unknown.”(43)

Following this line of thought, consider what other parts of the body are scrutinized by ultrasound technicians, such as the heart, where serious defects have soared nearly 250 percent between 1989 and 1996.(44) The list of unexplained birth defects is not a short one, and in light of what is emerging about prenatal ultrasound, scientists should take another look at all recent trends, as well as the baffling 30% increase in premature births since 1981, now affecting one in every eight children (45), with many showing subsequent neurological damage.(46)” – (1)

“Ultrasonic energy is known to affect cellular membranes and cell growth.  In fact, ultrasound is used as a therapy to accelerate bone growth following certain traumatic injuries.  In stem cell research, ultrasound has been shown to accelerate development of cells.  Knowing that stems cells are developing into neurons early in the fetal development, it’s quite possible that addition of ultrasound energy might shift that balance.” – (2)

“Like many people, I took for granted the idea that whomever approved ultrasound for clinical use made sure the power levels were low enough that the developing baby wasn’t cooked by its operation, or disintegrated like dirt on jewelry in the cleaning tank.”

“Not so fast,” Manny cautioned me . . . “When ultrasound was developed, it was first used late in pregnancy, when all these risk factors are minimized.  It was also used by trained staff and the machines, being new, were likely well calibrated. Most moms did not get ultrasound at all, and those who did typically received one or two.”

The situation today is totally different.  Many doctors do ultrasound much earlier in an effort to spot other problems, like Down’s syndrome.  It’s common for moms to get three, four, or more ultrasounds done.  Finally and most disturbing, many states have “ultrasound boutiques” in malls where moms can get ultrasounds as art; for the new baby scrapbook.” – (2)

“Ultrasound exposures longer than ten minutes can cause heating, which is clearly not good for a developing fetus, if the reason for the exposure is more vanity than medical. International guidelines suggest that exposures be as low as reasonably achievable (ALARA) to detect any problems with development. More than an hour is considered excessive. The more I learned about current prenatal ultrasound practice, the more concerned I became.” – (3)

Ten years later, researchers reported the same conclusion: “Existing evidence does not provide conclusive evidence that the use of routine umbilical artery Doppler ultrasound, or combination of umbilical and uterine Doppler ultrasound in low-risk or unselected populations benefits either mother or baby. Future studies should be designed to address small changes in perinatal outcome, and should focus on potentially preventable deaths,” (Alfirevic, et al, 2010). Ultrasound very early in pregnancy may carry the greatest risk. “Also, the particular sensitivity of the embryo to physical damage together with uncertainties of both risk and benefit suggest that caution should be applied to the scanning of early first trimester uncomplicated pregnancy,” (Barnett, 2002).” – (3)

“Yes! Today prenatal ultrasound exposure is used more frequently in each pregnancy and can be eight times more intense than it was 30 years ago. Most of the clinical studies establishing the safety profile of prenatal ultrasound were based on the use of machines prior to 1993 — a watershed year in ultrasound technology and its regulation. In 1993, the Food and Drug Administration (FDA) increased the allowable output of ultrasound machines eight-fold.

At the time of this increase, FDA failed to ensure that sonographers would be appropriately trained and credentialed to use the newer machines according to recommended international guidelines.” – (3) 

 Just for the record, I had 3 ultrasounds with Kingston (10 wk, 19 wk, and 41 wk) and one with Zekie (19 wk). I definitely wouldn’t do a first trimester ultrasound again, though that decision was made before I had Zeke and not related to anything in these articles.

Obviously this is only a sampling of articles on the topic, and as with so many debatable issues, there are two sides to the story. But I think this is an interesting topic and would love to hear your opinions on the matter, both pros and cons in regards to the increasing use of ultrasounds in prenatal care. Did you know there was even any possibility that ultrasound wasn’t safe? I sure didn’t before Zeke.

1. Midwifery Today – 2006

2. Autism Speaks – 2012

3. Huffington Post – 2014