Ultrasound Unsound? (Collection of info)
Here is a link to an interesting article entitled Ultrasound -
weighing the propaganda against the facts. It was written by the
author of Ultrasound Unsound?
I have seen other studies identifying negative side effects of
ultrasounds. One in particular found that as little as 1 ultrasound
could delay a child's speech by as much as 9 months. This study was
done in Canada, not the US. Other findings have suggested that the
increase in left-handedness among children who were scanned before
birth is linked to the ultrasound, which would show that the scan
does alter the brain in some way.
In the US, keep in mind that medical equipment does not undergo the
type of testing that a drug must go through to get on the market.
The scans used today are more invasive than the earlier ones, so it
will take a few more decades to really know the outcome. The recent
generations of children who have been scanned are in fact the guinea
pigs that will decide the safety of ultrasounds -- which have done
nothing to lower childbirth death rates, but have sent the C-section
rate dangerously high in the US.
The article above points out that the doppler, used to detect heart
tones on every prenatal visit unless you have a midwife (who uses a
fetalscope), may cause even more damage than the ultrasound.
This is straight from the journal "Epidemiology" (Dec 2001), and
suggests that ultrasound is associated with mild brain damage.
My boss, Dr. Mark Ellisman, is a world-renowned research scientist at UCSD
who specializes in imaging technologies for the study of brain structure
at the cellular level; he has personally found evidence of something
called "cavitation", which is the "rapid formation and collapse of vapor
pockets" in fluid within tissue. When my wife and I became pregnant
he warned me to keep the ultrasound as short as possible. He knows what
he's talking about.
Here's a relevant quote:
"Free radical production in amniotic fluid and blood plasma by medical
ultrasound, probably following gaseous cavitation, has been detected
by Crum et al (1987). This provides a likely mechanism for the
origin of the DNA damage. Because of these confirmations and a report
by Ellisman et al (1987) that diagnostic levels of ultrasound may disrupt
myelination in neonatal rats, the need for regulation, guidance, and
properly controlled clinical studies is clear."
Here's another useful link:
So please don't consider this a benign procedure or an opportunity
to get some pretty pictures. and *please* don't get an extra
3D ultrasound, which is a very long scan, to get the 3D picture
of your baby. There is a real risk, and it's just not worth it.
Do a Google search on "+ultrasound +cavitation" or "+ultrasound +Ellisman"
and convince yourself.
Just my .02
Weighing the Risks: What You Should Know about Ultrasound
By Sarah Buckley
Issue 102, September/October 2000
Ultrasonography was originally developed during World War II to detect
enemy submarines. Its use in medicine was pioneered in Glasgow, Scotland,
by Dr. Ian Donald, who first used ultrasound to look at abdominal tumors,
and later babies in utero in the mid-1950s.1 The use of ultrasound in
pregnancy spread quickly.
In westernized healthcare systems, ultrasound, which may be offered to a
pregnant woman either to investigate a possible problem at any stage of
pregnancy or as a routine scan at around 18 weeks, has become almost
universal in pregnancy. In Australia, where I live, 99 percent of pregnant
women have at least one scan, paid for in part by our federal government,
through Medicare. In fact, from 1997 to 1998 Medicare paid out AU$39
million for obstetric scans, compared to AU$54 million for all other
obstetric Medicare costs. In the US, the American College of Obstetrics and
Gynecology (ACOG) estimates that 60 to 70 percent of pregnant women are
scanned, despite an official statement from ACOG that recommends against
routine ultrasound.2 At a cost of roughly $300 per procedure, this
represents a cost of approximately $70 to $80 million each year in the US.
Besides routine scans, ultrasound can be prescribed to investigate problems
such as bleeding in early pregnancy. Later in pregnancy, ultrasound can be
used when a baby is not growing, or when breech or twin births are
suspected. In such cases, the information gained from ultrasound can be
very useful in decision-making, and generally most professionals support
the use of ultrasound in this context.
It is such use of routine prenatal ultrasound (RPU) that is more
controversial, as this practice involves scanning all pregnant women in the
hope of improving the outcome for some mothers and babies. RPU seeks to
gain four main types of information:
Estimated due date. Dating a pregnancy is most accurate at early stages,
when babies vary the least in size. By contrast, at 18 to 20 weeks the
expected date of delivery is only accurate to within a week either way.
Some studies have suggested, however, that an early examination or a
woman's own estimation of her due date can be as accurate as RPU.3,4
Unsuspected physical abnormalities. While many women are reassured by a
normal scan, in fact RPU detects only between 17 percent and 85 percent of
the one in 50 babies that have major abnormalities at birth.5,6 A recent
study from Brisbane, Australia, showed that ultrasound at a major women's
hospital missed about 40 percent of abnormalities, many of which are
difficult or impossible to detect.7 The major causes of intellectual
disability, such as cerebral palsy and Down syndrome, or heart and kidney
abnormalities, are unlikely to be picked up on a routine scan.
There is also a small chance that the diagnosis of an abnormality is false
positive. In some instances, normal babies have been aborted because of
false-positive diagnoses.8 A United Kingdom survey found that one in 200
babies aborted for major abnormalities were wrongly diagnosed.9
In addition to false positives, there are also uncertain cases in which the
ultrasound image cannot be easily interpreted, and the outcome for the baby
is not known. In one study involving babies at higher risk of
abnormalities, almost 10 percent of scans were uncertain.10 This can create
immense anxiety for the woman and her family that may not be allayed by the
birth of a normal baby: in the same study, mothers with questionable
diagnoses still had associated anxiety three months after the child's
birth. Uncertain findings also lead to repeated and/or prolonged scans,
increasing the expense, inconvenience, and dosage of ultrasound.
In some cases of uncertainty, further tests such as amniocentesis are
recommended. In such situations, there may be up to two weeks wait for
results, during which time a mother must consider whether or not she will
terminate the pregnancy if an abnormality is found. Even mothers who
receive reassuring news have felt that this process has interfered with
their relationship with their babies.11
Location of the placenta. A very low-lying placenta (placenta previa) puts
mother and baby at risk of severe bleeding, and usually necessitates a
cesarean section. However, 19 out of 20 women who have placenta previa
detected on RPU will be needlessly worried, as the placenta will
effectively move upwards as the pregnancy progresses.12 Furthermore,
detection of placenta previa by RPU has not been found to be safer than
detection in labor.13
Multiple fetuses. Ultrasound can detect the presence of more than one baby
at an early stage of pregnancy, but this knowledge affords no documented
health advantages for mother or babies, and, without RPU, almost all
multiple pregnancies are discovered before birth.14
Why Are RPUs So Popular?
Supporters of RPU argue that availability of ultrasonic information leads
to better outcomes for mother and baby. While this seems logical,
researchers have not found evidence of significant benefit from RPU, and
the issue of the safety of ultrasound has not yet been resolved.
From a research perspective, the most significant benefit of RPU is a small
reduction in perinatal mortality, that is the number of babies dying around
the time of birth. This is, however, merely a statistical reduction since
perinatal mortality rates do not include deaths that occur before five to
six months' gestation. Often when a baby is found to have a fatal
abnormality on RPU, the pregnancy is terminated before this time, excluding
the baby from perinatal statistics.
RPU proponents presume that early diagnosis and termination is beneficial
to women and their families. However, the discovery of a major abnormality
on RPU can lead to very difficult decision-making. Some women who agree to
have an ultrasound are unaware that they may get information about their
baby that they do not want, as they would not contemplate a termination.
Other women can feel pressured to have a termination, or at least feel some
emotional distancing from their "abnormal" baby.15
Furthermore, there is no evidence that women who have chosen termination
are, in the long term, psychologically better off than women whose babies
have died at birth. In fact, there are suggestions that the reverse may be
true in some cases.16 In choosing a possible stillbirth over a termination,
women at least get social acknowledgment and support, and are able to
grieve openly. Where termination has been chosen, women are unlikely to
share their story with others and can experience considerable guilt and
pain from the knowledge that they themselves chose the loss.17
Another purported benefit of RPU is a reduced risk of being induced for
being "overdue," because RPU dating gives a more certain estimated due
date. However, there is no clear evidence that this is true, as the
possibility of induction is more determined by hospital or doctor policy
than by the availability of RPU.19
Many supporters of RPU claim that it's a pleasurable experience, and
contributes to bonding between mother (and father, if he is present) and
baby. While it is true that it can be exciting to get a first glimpse of
one's baby in utero, there is no evidence that it helps attachment or
encourages healthier behavior toward the baby.20 For most women, bonding
occurs naturally when they begin to feel fetal movements at 16 to 20 weeks.
Reasons for Concern
Ultrasound waves are known to affect living tissues in at least two ways.
First, the sonar beam heats the highlighted area by about 1°C (2°F). This
is presumed to be insignificant, based on whole-body heating in pregnancy,
which seems to be safe up to 2.5°C (5°F).21 The second effect is
cavitation, where the small pockets of gas that exist within mammalian
tissue vibrate and then collapse. In this situation "...temperatures of
many thousands of degrees Celsius in the gas create a wide range of
chemical products, some of which are potentially toxic."22 The significance
of cavitation in human tissue is unknown.
A number of studies have suggested that these effects are of real concern
in living tissues. The first study indicating problems analyzed cells grown
in the lab. Cell abnormalities caused by exposure to ultrasound were seen
to persist for several generations.23 Another study showed that, in newborn
rats (who are at a similar stage of brain development as humans at four to
five months in utero), ultrasound can damage the myelin that covers
nerves,24 indicating that the nervous system may be particularly
susceptible to damage from this technology. In 1999, an animal study by
Brennan and colleagues, reported in New Scientist,25 showed that exposing
mice to dosages typical of obstetric ultrasound caused a 22 percent
reduction in the rate of cell division, and a doubling of the rate of cell
death in the cells of the small intestine.
Studies on humans exposed to ultrasound have shown possible adverse
effects, including premature ovulation,26 preterm labor or miscarriage,27,
28 low birthweight,29 poorer condition at birth,30, 31 dyslexia,32 delayed
speech development,33 and less right-handedness,34, 35 a factor which in
some circumstances can be a marker of damage to the developing brain. In
addition, one Australian study showed that babies exposed to five or more
ultrasounds were 30 percent more likely to develop intrauterine growth
retardation (IUGR)--a condition that ultrasound is often used to detect.36
Two long-term randomized controlled trials, comparing exposed and unexposed
children's development at eight to nine years of age, found no measurable
effect from ultrasound.37, 38 However, as the authors note, intensities
used today are many times higher than in 1979 to 1981. A later report of
one of these trials39 indicated that scanning time was only three minutes.
More studies are obviously needed in this area, particularly in Doppler
ultrasound, where exposure levels are much higher, and in vaginal
ultrasound, where there is less tissue shielding the baby from the
A further problem with studying ultrasound's effect is the huge range of
output, or dose, possible from a single machine. Modern machines can give
comparable ultrasound pictures using either a lower or a 5,000 times higher
dose,40 and there are no standards to ensure that the lowest dose is used.
Because of the complexity of machines, it is difficult to even quantify the
dose given in each examination.41 In the US, as in Australia, training is
voluntary (even for obstetricians), and the skill and experience of
operators varies widely.
In all the research done on ultrasound, there has been very little interest
in women's opinions of RPU, and the consequences of universal scanning for
women's experience of pregnancy. In her thoughtful book on prenatal
diagnosis, The Tentative Pregnancy,42 Barbara Katz Rothman suggests that
the large numbers of screening tests currently being offered to check for
abnormalities makes every pregnancy tentative until reassuring results come
Ultrasound is not compulsory, and I suggest that each woman consider the
risks, benefits, and implications of scanning for her own particular
situation. If you decide to have a scan, be clear about the information
that you do and do not want to be told. Have your scan done by an operator
with a high level of skill and experience (usually this means performing at
least 750 scans per year) and say that you want the shortest scan possible.
If an abnormality is found, ask for counseling and a second opinion as soon
as practical. And remember, it's your baby and your choice.
1. Ann Oakley, "The History of Ultrasonography in Obstetrics," Birth 13,
no. 1 (1986): 8-13.
2. American College of Obstetricians and Gynecologists, "Routine Ultrasound
in Low-Risk Pregnancy, ACOG Practice Patterns: Evidence-Based Guidelines
for Clinical Issues," Obstetrics and Gynecology 5 (August 1997).
3. O. Olsen et al., "Routine Ultrasound Dating Has Not Been Shown to Be
More Accurate Than the Calendar Method," Br J Obstet Gynaecol 104, no. 11
4. H. Kieler, O. Axelsson, S. Nilsson, and U. Waldenstrom, "Comparison of
Ultrasonic Measurement of Biparietal Diameter and Last Menstrual Period as
a Predictor of Day of Delivery in Women with Regular 28-Day Cycles,"
Acta-Obstet-Gynecol-Scand 75, no. 5 (1993): 347-349.
5. B. G. Ewigman, J. P. Crane, F. D. Frigoletto et al., "Effect of Prenatal
Ultrasound Screening on Perinatal Outcome," N Engl J Med 329, no. 12
6. C. A. Luck, "Value of Routine Ultrasound Scanning at 19 Weeks: A Four
Year Study of 8849 Deliveries," British Medical Journal 34, no. 6840
7. F. Y. Chan, "Limitations of Ultrasound," paper presented at Perinatal
Society of Australia and New Zealand 1st Annual Congress, Freemantle, 1997.
8. AIMS UK, "Ultrasound Unsound?," AIMS UK Journal 5, no. 1 (Spring 1993).
9. I. R. Brand, P. Kaminopetros, M. Cave et al., "Specificity of Antenatal
Ultrasound in the Yorkshire Region: A Prospective Study of 2261 Ultrasound
Detected Anomalies," Br J Obstet Gynaecal 101, no. 5 (1994): 392-397.
10. J. W. Sparling, J. W. Seeds, and D. C. Farran, "The Relationship of
Obstetric Ultrasound to Parent and Infant Behavior," Obstet Gynecol 72, no.
6 (1988): 902-907.
11. A. Brookes, "Women's Experience of Routine Prenatal Ultrasound,"
Healthsharing Women: The Newsletter of Healthsharing Women's Health
Resource Service (Melbourne, Australia) 5, no.s 3, 4 (December 1994-March
12. MIDIRS, Informed Choice for Professionals, Ultrasound Screening in the
First Half of Pregnancy: Is It Useful for Everyone? (UK: MIDIRS and the NHS
Centre for Reviews and Dissemination, 1996).
13. A. Saari-Kemppainen, O. Karjalainen, P. Ylostalo et al., "Ultrasound
Screening and Perinatal Mortality: Controlled Trial of Systematic One-stage
Screening in Pregnancy," The Lancet 336, no. 8712 (1990): 387-391.
14. See Note 12.
15. See Note 11.
16. D. Watkins, "An Alternative to Termination of Pregnancy," The
Practitioner 233, no. 1472 (1989): 990, 992.
17. See Note 12.
21. "American Institute of Ultrasound Medicine Bioeffects Report 1988," J
Ultrasound Med 7 (September 1988): S1-S38.
23. D. Liebeskind, R. Bases, F. Elequin et al., "Diagnostic Ultrasound:
Effects on the DNA and Growth Patterns of Animal Cells," Radiology 131, no.
1 (1979): 177-184.
24. M. H. Ellisman, D. E. Palmer, and M. P. Andre, "Diagnostic Levels of
Ultrasound May Disrupt Myelination," Experimental Neurology 98, no. 1
25. Brennan et al., "Shadow of Doubt," New Scientist 12 (June 1999): 23.
26. J. Testart, A. Thebalt, E. Souderis, and R. Frydman, "Premature
Ovulation after Ovarian Ultrasonography," Br J Obstet Gynaecol 89, no. 9
27. See Note 13.
28. R. P. Lorenz, C. H. Comstock, S. F. Bottoms, and S. R. Marx,
"Randomised Prospective Trial Comparing Ultrasonography and Pelvic
Examination for Preterm Labor Surveillance," Am J Obstet Gynecol 162, no. 6
29. J. Newnham, S. F. Evans, C. A. Michael et al., "Effects of Frequent
Ultrasound During Pregnancy: A Randomised Controlled Trial," The Lancet
342, no. 8876 (1993): 887-891.
30. S. B. Thacker, "The Case of Imaging Ultrasound in Obstetrics: A
Review," Br J Obstet Gynaecol 92, no. 5 (1985): 437-444.
31. J. P. Newnham et al., "Doppler Flow Velocity Wave Form Analysis in High
Risk Pregnancies: A Randomised Controlled Trial," Br J Obstet Gynaecol 98,
no. 10 (1991): 956-963.
32. C. R. Stark, M. Orleans, A. D. Havercamp et al., "Short and Long Term
Risks after Exposure to Diagnostic Ultrasound in Utero," Obstet Gynecol 63
33. J. D. Campbell et al., "Case-control Study of Prenatal Ultrasonography
in Children with Delayed Speech," Can Med Ass J 149, no. 10 (1993): 1435-
34. K. A. Salvesen, L. J. Vatten, S. H. Eik-nes et al., "Routine
Ultrasonography in Utero and Subsequent Handedness and Neurological
Development," British Medical Journal 307, no. 6897 (1993) 159-164.
35. H. Kieler, O. Axelsson, B. Haguland et al., "Routine Ultrasound
Screening in Pregnancy and the Children's Subsequent Handedness," Early
Human Development 50, no. 2 (1998): 233-245.
36. See Note 31.
37. K. A. Salvesen, L. S. Bakketeig, S. H. Eik-nes et al., "Routine
Ultrasonography in Utero and School Performance at Age 8-9 Years," The
Lancet 339, no. 8785 (1992):85-89.
38. H. Kieler, G. Ahlsten, B. Haguland et al., "Routine Ultrasound
Screening in Pregnancy and the Children's Subsequent Neurological
Development," Obstet Gynecol 91, no. 5 (1998): 750-756.
39. See Note 37.
40. H. B. Meire, "The Safety of Diagnostic Ultrasound," Br J Obstet
Gynaecol 94 (1987): 1121-1122.
41. K. J. W. Taylor, "A Prudent Approach to Ultrasound Imaging of the Fetus
and Newborn," Birth 17, no. 4 (1990): 218-223.
42. Barbara Katz Rothman, The Tentative Pregnancy: How Amniocentesis
Changes the Experience of Motherhood (New York: W. W. Norton, 1993).
For more information on ultrasound, see the following articles in past
issues of Mothering: "Ultrasound: More Harm Than Good?" no. 77; "The
Trouble with Ultrasound," no. 57; "How Sound Is Ultrasound?" no. 34;
"Ultrasound," no. 24; and "Diagnostic Ultrasound," no. 19.
Sarah Buckley (40) is a New Zealand-trained GP (family MD), and still in
training as partner to Nicholas. Mother of Emma (9), Zoe (6), and Jacob
(4), she is currently expecting her fourth baby and lives in Brisbane,
Australia, where she writes about pregnancy, birth, and parenting.
Shadow of a doubt
by Rob Edwards
ULTRASOUND SCANS can stop cells from dividing and make them commit suicide.
research team in Ireland say this is the first evidence that routine scans,
which have let doctors peek at fetuses and internal organs for the past 40
years, affect the normal cell cycle.
A team led by Patrick Brennan of University College Dublin gave 12 mice an
8-megahertz scan lasting for 15 minutes. Hospital scans, which reflect
inaudible sound waves off soft tissue to produce images on a monitor, use
frequencies of between 3 and 10 megahertz and can last for up to an hour
The researchers detected two significant changes in the cells of the small
intestine in scanned mice compared to the mice that hadn't been scanned.
and a half hours after exposure, there was a 22 per cent reduction in the
rate of cell division, while the rate of programmed cell death or
had approximately doubled.
Brennan believes there will be similar effects in humans. "It has been
assumed for a long time that ultrasound has no effect on cells," he says.
now have grounds to question that assumption."
Brennan stresses, however, that the implications for human health are
uncertain. "There are changes happening, but we couldn't say whether they
harmful or harmless," he explains. The intestine is a very adaptable organ
that can compensate for alterations in the cell cycle, says Brennan.
It is possible that the sound waves damage the DNA in cells, delaying cell
division and repair. Brennan suggests that ultrasound might be switching on
the p53 gene which controls cell deaths. This gene, dubbed "the guardian of
the genome", produces a protein that helps cells recognise DNA damage and
then either self-destruct or stop dividing.
Studies in the early 1990s by researchers at the University of Rochester in
New York and the Batelle Pacific Northwest Laboratories in Richland,
Washington, showed that tissue heating due to ultrasound can cause bleeding
in mouse intestines. Ultrasonographers now tune the power of scans to reduce
But Brennan's work is the first evidence that scans create changes in cells.
"Our results are preliminary and need further investigation," he says. The
team presented their results at the Radiology 1999 conference in Birmingham
last month and are now preparing them for submission to a peer-reviewed
Alex Elliott, a researcher in clinical physics at the University of Glasgow,
thinks that Brennan's results are important and should be followed with
further studies. "If the conditions of his experiments really compare to the
clinical use of ultrasound," he says, "we may have to review the current
>From New Scientist, 12 June 1999
Here are some excerpts about ultrasound from "What Doctors Don't Tell You"
by Lynne McTaggart. "No well controlled study has yet proved that
routine scanning of prenatal patients will improve the outcome of
pregnancy" - official statement from American College of Obstetrics &
Gynecology in 1984
Some studies show that, with ultrasound, you are more likely to lose your
baby. A study from Queen Charlotte's and Chelsea Hospital in London found
that women having doppler ultrasound were more likely to lose their babies
than those who received only standard neonatal care (17 deaths to 7).
A Norwegian study of 2,000 babies found that those subjected to routine
ultrasound scanning were 30% more likely to be left-handed than those sho
weren't scanned. An Australian study demonstraates that frequent scans
increased the proportion of growth-restricted babies by a third, resulting
in a higher number of small babies. Exposure to ultrasound also caused
delayed speech, according to Canadian researcher Professor James Campbell.
The International Childbirth Education Association has maintained that
ultrasound is most likely to affect development (behavioral &
neurological), blood cells, the immune system, & a child's genetic makeup.
Besides the safety issue, there are considerable questions about accuracy.
There is a significant chance that your scan will indicate a problem when
there isn't one, or fail to pick up aa problem actually there. One study
found a "high rate" of false positives, 17% of the pregnant women scanned
were shown to have small-for-dates babies, when only 6% actually did - an
error rate of nearly one out of three. Another study from Harvard showed
that among 3,100 scans, 18 babies were erroneously labeled abnormal, and 17
fetuses with problems were missed.
this is from another list...
<<<According to Anne Frye, midwife and author of "Understanding Lab Work in
the Childbearing Year" (4th Ed.)p. 405
Doppler Devices: Many women do not realize that doppler fetoscopes are
ultrasound devices. (apparently, neither do many care providers. Time
after time, women are assured by doctors and even some nurse midwives
that a doppler is not an ultrasound device.) . . . .
Not well publicized for obvious reasons, doppler devices expose the fetus
to more powerful ultrasound than real time (imaging) ultrasound exams.
One minute of doppler exposure is equal to 35 minutes of real time
ultrasound. This is an important point for women to consider when
deciding between an ultrasound exam and listening with a doppler to
determine viability in early pregnancy. . . . .
If you have a doppler, put it aside and make a concerted effort to learn
to listen yourself! Save your doppler for those rare occasions when you
cannot hear the heart rate late into pushing or to further investigate
suspected fetal death. " copyright l990, Anne Frye, B.H. Holistic
Personally, after 23 years of attending births, I would not permit a
doppler in my house if I were pregnant. You always know that something
is ultrasound because there will be "jelly" involved. If you want a
cheap listening device for the baby's heart just save the core from a
roll of toilet paper. Put one end on the lower belly and the other on
hubby's ear. If you want to know your baby is doing well, count the
fetal movements in a day. Starting at 9 a.m. count each time the baby
kicks. There should be l0 distinct movements by 3 p.m.
I think it's sad that some people will do anything to make a buck of the
huge pregnant market in North America. Please feel free to forward this
post on to any other lists.
Gloria Lemay, Vancouver BC
Wise Woman Way of Birth Courses
This made me wonder what ultrasound does to developing babies if it
can have such a drastic effect on a testicle.
Prenatal Testing and Informed Consent: Base Your Choices on the Evidence
By Peggy O'Mara
Issue 120, September/October 2003