A letter to ECMUS - Ultrasound safety - the dotty old aunt is at it again !

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There are two ways to evacuate a crowded lecture hall at an ultrasound conference in a very short time:

1. shout "fire"

2. put a slide on the screen with the message "the scheduled lecture on 3D imaging of fetal genitalia has been cancelled and is replaced by a lecture on ultrasound safety"

However, ultrasound safety, particularly safety of ultrasound performed during pregnancy has received a boost in recent months. Not, as one might think, because of an increasing awareness that the ever more widespread use of pulsed-wave and color Doppler in the first trimester of pregnancy might potentially harm embryos and fetuses who have to undergo this sound energy impact for screening purposes.

The sudden resurgence of interest in ultrasound safety particularly in the US is entirely the consequence of a new turf war: Commercial 3-D ultrasound studios promising cute golden 3-D images of cuddly fetuses are springing up in shopping malls all over North America and, increasingly, in Europe. Tom Cruise got unexpected additional fame when he acquired a top of the range 3-D ultrasound machine to look at the development of his wife's pregnancy, and to visualize his unborn baby at home.

A lot of people, representatives of the medical profession and lawmakers have spoken up and declared they are worried about the potential harm these non-medical uses might cause.

But let's face it - in which situation is more sound energy being delivered onto the fetus: during a 28 week "facing" scan with 3 D ultrasound or an 11 week scan where Doppler of the fetal ductus venosus and the tricuspidal valve has to be performed in order to screen the fetus for its potential to have trisomy 21?

Parents love the reassuring thump-thump-thump and the complex waveform patterns we produce at these cardiac Doppler examinations in the first trimester and we reassure them that ultrasound is harmless in our hands.

However, most first-trimester ultrasound operators have no idea what MI and TI mean, concern for ultrasound safety is considered thoroughly un-cool as is attendance at sessions dedicated to this boring subject.

Ultrasound safety is treated like a slightly deranged dotty old aunt who is confined to her crammed garret and only once in a while is dressed up, taken out, told to bash the babyview-studios with her rolled-up umbrella and then taken up to her garret and locked up again.

Prof Christoph Brezinka MD PhD, Innbruck, Austria

Chairman Perinatal Doppler Focus Group of ISUOG

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