Trusted Information for Healthy Pregnancies
3D ultrasound
Safety of ‘souvenir’ ultrasound baby scans in question
Feb 2nd
Parents-to-be should weigh the possible risks of going for non-essential scans purely to get keepsake pictures of their unborn babies, experts conclude.
Although ultrasound scans to check the baby's health are entirely justifiable and safe, the Health Protection Agency is concerned about "boutique" scanning.
Its independent advisory board looked at the available evidence for any possible health ill effects.
It said more research is needed to determine the long-term consequences.
There have been some unconfirmed reports suggesting possible neurological effects on the unborn child.
The concern is that with souvenir scans the beam of ultrasound stays static over the baby's head for longer in order to get a sharp mug shot.
Some studies have linked ultrasound scans to higher rates of left-handedness in baby boys.
The report found no evidence to suggest that routine ultrasound scans used for antenatal checks in hospitals negatively affected the health of babies.
But the evidence surrounding commercial ultrasound use was too patchy to make a judgment.
Chairman of the report, Professor Anthony Swerdlow, said: "Ultrasound has been widely used in medical practice for 50 years, and there is no established evidence of specific hazards from diagnostic exposures.
"However, in the light of the widespread use of ultrasound in medical practice, its increasing commercial use for 'souvenir' fetal imaging, and the unconfirmed indications of possible neurological effects on the fetus, there is a need for further research on whether there are any long-term adverse effects of diagnostic ultrasound."
The British Medical Ultrasound Society agreed with the HPA findings.
They urged all patients who had diagnostic scans booked to keep their scheduled appointments as these ultrasound scans have been arranged for a clinical purpose.
They said it was also fine to take home keepsake pictures from these scans - but advised parents against seeking scans solely for the purpose of getting a "nice snapshot for the baby book".
Source
Blood test tells fetal sex in early pregnancy
Jan 19th
Normally, parents who want to know the sex of their baby before it's born find out through ultrasound done in the second trimester. A blood test that can be done early in pregnancy is highly accurate at determining the sex of the fetus, however, a new study finds.
The test is important, write the authors of the study, because in some cases, there are medical reasons to determine fetal sex earlier. That has traditionally meant invasive tests, like amniocentesis, which carry a small risk of miscarriage.
Consequently, maternal blood tests that pick up certain markers of fetal sex have been developed and put into use in recent years. So far, research has shown the accuracy of these tests to vary widely, depending on the methods used.
In this latest study, published in the journal Obstetrics & Gynecology, researchers in the Netherlands found that the testing method used at their center was 100 percent accurate in determining fetal sex among nearly 200 pregnant women.
Part of what's new about the findings is that they show the effectiveness of blood testing as it is done in routine practice -- and not just in the research setting, Dr. Ellen van der Schoot, of Sanquin Research Amsterdam, told Reuters Health in an email. The study does not discuss costs, nor when the test might be available to the general public.
Still, the findings, according to van der Schoot and her colleagues, support using the tests in cases where fetal sex is important in detecting or managing certain inherited medical conditions.
For example, congenital adrenal hyperplasia (CAH) is a genetic disorder that causes girls to develop abnormal external genitalia and male-like characteristics like a deep voice and excessive body hair.
It is possible, however, to treat the disorder with the steroid dexamethasone as soon as pregnancy is established, so knowing the fetal sex sooner is better than later.
Similarly, fetal sex is key in genetic disorders linked to abnormalities in the X chromosome. These disorders -- such as hemophilia and Duchenne/Becker muscular dystrophy -- are almost always seen in boys rather than girls, because boys inherit only one X chromosome, from the mother. (Girls inherit an X chromosome from each parent.)
In cases where a mother is known to carry an X-linked genetic defect, blood testing for fetal sex tells doctors whether further, invasive testing for the particular genetic disorder should be done. If the fetus is female, invasive tests can be avoided.
In the current study, van der Schoot and her colleagues looked at 201 pregnant women who had blood testing at their lab between 2003 and 2009. The test, done as early as the seventh week of pregnancy, determines fetal sex by looking for two genes found on the Y sex chromosome.
Only men carry the Y chromosome, so when these genes were found in a pregnant woman's blood sample, the fetus was assumed to be male. When the test did not detect the genes, the mother's blood was analyzed further to confirm that certain other fetal DNA was present; with that confirmation, the researchers concluded that the fetus was female.
Of the 201 women in this study, blood tests gave conclusive results to 189. In each case, that result turned out to be correct.
Source
Ultrasounds to be shown live to fathers via iPhone
Jan 11th
The new technology, which transmits video images via the 3G mobile phone network, was unveiled at the Consumer Electronics Show in Las Vegas.
Dr Topol, chief medical officer of the West Wireless Health Institute, which promotes the use of mobile phone technology in healthcare, demonstrated the technique by broadcasting images of an ultrasound examination in Sweden.
He said the new technology was designed to send ultrasound videos to doctors, friends and family, but could even be used to broadcast the examination to “Facebook, Twitter and the whole social networking scene”.
Dr Topol also showed the crowd an Apple iPhone application designed to allow doctors to check the vital signs of patients from any location.
Dr Topol said mobile phone applications have been developed to spot the early warning signs of the top ten causes of hospitalizations in the US, including Alzheimers, breast cancer and diabetes.
He said the technology had the potential to save hundreds of millions of dollars by allowing doctors to act pre-emptively and avoid expensive hospital treatment.
“These things are empowering consumers to take charge of their health,” he said. “You know how we check our emails? Next year we will be sitting here with a Band-Aids on checking our vital signs.”
Source
Ultrasounds during pregnancy soar
Jan 5th
The number of ultrasounds administered to pregnant women has soared over the past decade, new research suggests.
A new study finds that the annual number of ultrasounds rose to 3,264 per 1,000 pregnancies in 2006 from 2,055 per 1,000 in 1996.
The proportion of pregnancies with at least four ultrasounds in the second or third trimesters grew to 18.7 per cent in 2006 from 6.4 per cent in 1996. Women who were deemed low-risk by their physicians received more ultrasounds than women categorized as high-risk.
Women fell into a high-risk category if the pregnancy endangered their life, required a genetics consultation or amniocentesis, or if they had a history of complications in a previous pregnancy. All other pregnancies were considered low-risk.
The study of 1,399,389 single deliveries was conducted between 1996 and 2006 by researchers at McMaster University in Hamilton, Toronto's Institute for Clinical Evaluative Sciences, and St. Michael's Hospital in Toronto. It is published in the Jan. 4 issue of the Canadian Medical Association Journal.
"Although guidelines generally recommend that two ultrasound examinations be performed in a pregnancy without complications — one in the first trimester for measurement of nuchal translucency to screen for aneuploidy (a chromosomal abnormality), and one in the second trimester to screen for fetal anomalies — it is conceivable that the proliferation of prenatal ultrasonography reflects changes in maternal risk over time," write the authors.
The authors speculate that many factors could be involved in the spike in ultrasounds. They attribute it to "defensive medicine," meaning doctors are erring on the side of caution, the desire of physicians to reduce patient anxiety, requests from mothers and even the "entertainment value of seeing one's fetus."
Over the course of the 10-year study period, the proportion of women aged 34-54 rose to 20.4 per cent of all pregnancies from 15.1 per cent in 1996. The number of high-risk pregnancies also grew to 19.3 per cent from 15.7 per cent.
The study's authors also point out that the cost of administering ultrasounds to women at low risk of pregnancy complications is high. At $64 per exam in Ontario, the cumulative total of ultrasound exams in the province since 1996 is $30 million.
It also questions the safety of multiple ultrasounds, noting that some studies have shown that frequent scans may cause the fetus's growth to be restricted, delayed speech and non-right-handedness. As well, the study points out that benign findings on ultrasounds can lead to invasive and potentially risky procedures that are not necessary, such as amniocentesis.
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