Safety Aspects of Perinatal Ultrasound

Ragnar Sande; Klaus-Vitold Jenderka; Carmel M. Moran; Susana Marques; J. F. Jimenez Diaz; Gail ter Haar; Karel Marsal; Christoph Lees; Jacques S. Abramowicz; Kjell Åsmund Salvesen; Piero Miloro; Andrea Dall’Asta; Christoph Brezinka; Christian Kollmann

doi:10.1055/a-1538-6295

Ultraschall in der Medizin - European Journal of Ultrasound, Table of Contents

Ultraschall Med 2021; 42(06): 580-598
DOI: 10.1055/a-1538-6295

Continuing Medical Education

Safety Aspects of Perinatal Ultrasound

Sicherheitsaspekte des perinatalen Ultraschalls

Ragnar Sande

¹Department of Obstetrics and Gynecology, Stavanger University Hospital, Stavanger, Norway

²Department of Clinical Science, University of Bergen, Norway

,

Klaus-Vitold Jenderka

³FB INW, Hochschule Merseburg, Germany

,

Carmel M. Moran

⁴Centre for Cardiovascular Science, Edinburgh University, Edinburgh, United Kingdom of Great Britain and Northern Ireland

,

Susana Marques

⁵Department of Gastroenterology and Digestive Endoscopy, Champalimaud Foundation, Lisboa, Portugal

,

J. F. Jimenez Diaz

⁶Sport Sciences Faculty, Castilla La Mancha University Education Faculty of Toledo, Spain

⁷Sport Medicine Department, UCAM, Murcia, Spain

,

Gail ter Haar

⁸Physics, Institute of Cancer Research, Sutton, United Kingdom of Great Britain and Northern Ireland

,

Karel Marsal

⁹Department of Obstetrics and Gynecology, Lund University, Lund, Sweden

,

Christoph Lees

¹⁰Center for Fetal Care, Queen Charlotte's and Chelsea Hospital, London, United Kingdom of Great Britain and Northern Ireland

,

Jacques S. Abramowicz

¹¹Department of Obstetrics and Gynecology, University of Chicago Medical Center, CHICAGO, United States

¹²Safety Committee, World Federation for Ultrasound in Medicine and Biology, Chicago, United States

,

Kjell Åsmund Salvesen

¹³Department of Obstetrics and Gynecology, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway

¹⁴Department of Clinical and Molecular Medicine, Norwegian University of Science and Technology, Trondheim, Norway

,

Piero Miloro

¹⁵Ultrasound and Underwater Acoustics, National Physical Laboratory, Teddington, United Kingdom of Great Britain and Northern Ireland

,

Andrea Dall’Asta

¹⁶Department of Medicine and Surgery, Obstetrics and Gynecology Unit, Universita degli Studi di Parma, Italy

,

Christoph Brezinka

¹⁷Department of Obstetrics and Gynecology, Medical University Innsbruck Department of Gynecology, Innsbruck, Austria

,

Christian Kollmann

¹⁸Center for Medical Physics & Biomedical Engineering, Medical University Vienna, Austria

› Author Affiliations

Abstract

Ultrasound safety is of particular importance in fetal and neonatal scanning. Fetal tissues are vulnerable and often still developing, the scanning depth may be low, and potential biological effects have been insufficiently investigated. On the other hand, the clinical benefit may be considerable. The perinatal period is probably less vulnerable than the first and second trimesters of pregnancy, and ultrasound is often a safer alternative to other diagnostic imaging modalities. Here we present step-by-step procedures for obtaining clinically relevant images while maintaining ultrasound safety. We briefly discuss the current status of the field of ultrasound safety, with special attention to the safety of novel modalities, safety considerations when ultrasound is employed for research and education, and ultrasound of particularly vulnerable tissues, such as the neonatal lung. This CME is prepared by ECMUS, the safety committee of EFSUMB, with contributions from OB/GYN clinicians with a special interest in ultrasound safety.

Zusammenfassung

Die Sicherheit des Ultraschalls ist bei der Untersuchung von Föten und Neugeborenen von besonderer Bedeutung. Fetales Gewebe ist empfindlich und befindet sich meist noch in der Entwicklung, die Eindringtiefe kann gering sein und mögliche biologische Effekte sind nur unzureichend untersucht worden. Andererseits kann der klinische Nutzen beträchtlich sein. In der Perinatalperiode ist der Fötus wohl weniger gefährdet als im ersten und zweiten Trimester der Schwangerschaft, und Ultraschall ist häufig eine sicherere Alternative verglichen mit anderen diagnostischen bildgebenden Verfahren. Hier stellen wir Schritt für Schritt das Vorgehen vor, um klinisch relevante Bilder zu erhalten und gleichzeitig die Ultraschallsicherheit zu gewährleisten. Wir erörtern kurz den aktuellen Stand auf dem Gebiet der Ultraschallsicherheit, mit besonderem Augenmerk auf der Sicherheit neuer Modalitäten, Überlegungen zur Sicherheit beim Einsatz von Ultraschall in Forschung und Ausbildung sowie die Sonografie besonders gefährdeter Gewebe, wie z. B. der neonatalen Lunge. Diese CME-Arbeit wurde von ECMUS, dem Sicherheitsausschuss der EFSUMB, unter Mitwirkung von Gynäkologen mit besonderem Interesse an der Ultraschallsicherheit erstellt.

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