| Physicians should
continue to be prudent about the use of ultrasound and perform the
study only when medically necessary and when benefits outweigh risk,
according to the American College of Radiology. The advice comes in
the wake of recent findings by Yale researchers that link prenatal
ultrasound exposure to brain damage.
During fetal development, neurons of the brain
migrate to their correct positions. In a study of 335 mice, the
researchers found that exposing pregnant mice to ultrasound waves at
frequencies of 6.7 MHz for 30 minutes or more interfered with this
normal migration in their fetuses. This interference could
potentially result in brain abnormalities such as mental retardation
and seizures.
Results were published in August in the
Proceedings of the National Academy of Sciences. Further research is
needed to determine whether the results could apply to humans.
The study has unveiled a risk previously not
known, according to Dr. Carol Rumack, head of the American College
of Radiology ultrasound commission. The study provides further proof
that ultrasound keepsake videos should not be performed and that
ultrasound equipment should be used only by qualified people, said
Rumack, a professor of pediatrics and radiology at the University of
Colorado School of Medicine
The effects on neural migration were the
result of direct prolonged exposure of the fetal mouse brain to
ultrasound waves. Ultrasound examinations in pregnant women with
abdominal pain are targeted to the evaluation of the mother's
abdomen and not to the fetus. Typically, the fetal brain is not
exposed or is exposed during very short periods of time during the
examination.
In clinical practice, physicians often perform
ultrasound for 30 minutes, but they typically move the probe around
on the patient. In a quest to find the perfect 3D image of a
developing child, however, others might hold the probe down in one
spot for longer periods of time, increasing the risk of fetal
damage.
The Yale study was performed in mice who were
in the equivalent of the human third trimester of pregnancy.
Traditionally, concern about performing imaging studies has centered
on the first trimester, when basic organs are developing. The mouse
study suggests concern in later stages might also be appropriate.
It's important for the public to remember that
the imaging study involves putting ultrasound energy into the fetus,
Rumack said.
"One should not use ultrasound as if it
were a digital camera," she said.
In March, the FDA held a hearing to determine
whether low-level ultrasound monitors should become available over
the counter as an aid for tracking fetal heart rates. Currently,
they are available for sale and rental with a doctor's referral.
As ACR representative, Rumack testified at the
hearing against the proposal to expand access. If a woman used the
monitor at home alone, a physician would not be available to offer a
sound medical opinion about the baby's health, and if monitors were
available to the public without a doctor's knowledge, many babies
could be exposed to ultrasound with no oversight of potential
effects, she said.
The Yale study raises new concerns not
discussed at the meeting. A monitor left on all day could
potentially cause damage to the brain of the developing fetus. Based
on the new data, women with normal pregnancies should not take the
risk of continuous ultrasound exposure for non-medical purposes,
Rumack said.
Read the full research report: Prenatal
exposure to ultrasound waves impacts neuronal migration in mice
.
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