Safety aspects of ultrasound in prenatal diagnosis

Ultrasound was used for the first time in pregnancy in the 1960 s and then found broader clinical application in the 70 s and particularly in the 80 s, thereby revolutionizing obstetrics and ultimately resulting in the development of a new subspecialty: prenatal diagnosis and perinatal medicine. This means that ultrasound has been used for more than 40 years in pregnancy to examine fetuses. This development was facilitated on the one hand by the ease of use of the method and the resulting broad availability and on the other hand by the fact that ultrasound is an imaging method that does not require the use of physical radiation. This resulted in early differentiation from diagnostic radiology (classic abdominal X-ray, pelvic X-ray, amniofetography) and later also from computed tomography. Magnetic resonance imaging (MRI) has the potential to supplement ultrasound for targeted issues but is still very cost-intensive and has numerous limitations.

Publication History

Article published online:
07 April 2020

• References

• 1 Heling KS, Kozlowski P, Dudwiesus H. Neue Strahlenschutzverordnung – Ultraschall in der Schwangerschaft ist gefährlich? Eine nicht haltbare Feststellung. Ultraschall in Med 2019; 40: 266-268
• 2 Marsal K. The output display standard: has it missed its target?. Ultrasound Obstet Gynecol 2005; 25: 211-214
• 3 Deane C, Lees C. Doppler obstetric ultrasound: a graphical display of temporal changes in safety indices. Ultrasound Obstet Gynecol 2000; 15: 418-423
• 4 Drukker L, Droste R, Chatelain P. et al. Safety Indices of Ultrasound: Adherence to Recommendations and Awareness During Routine Obstetric Ultrasound Scanning. Ultraschall in Med 2020; 41: 1-8
• 5 American Institute of Ultrasound in Medicine. Official Statement: Recommended Maximum Scanning Times for Displayed Thermal Index (TI) Values 2016. https://www.aium.org/officialStatements/65 (May 2, 2019)
• 6 Safety Group of the British Medical Ultrasound Society. Guidelines for the safe use of diagnostic ultrasound equipment 2009. https://www.bmus.org/static/uploads/resources/BMUS-Safety-Guidelines-2009-revision-FINAL-Nov-2009.pdf (Accessed May 2nd 2019)
• 7 Helmy S, Bader Y, Koch M. et al Measurement of Thermal Effects of Doppler Ultrasound: An In Vitro Study. PLoS ONE 2015; 10: e0135717 . doi:10.1371/journal.pone.0135717 
• 8 Kollmann C, Jenderka KV, Moran CM. et al. EFSUMB Clinical Safety Statement for Diagnostic. Ultrasound – (2019 revision). Ultrasound in Med 2019;
• 9 Duggan PM, Liggins GC, Barnett SB. Ultrasonic heating of the brain of the fetal sheep in utero. Ultrasound Med Biol 1995; 21: 553-560
• 10 Abramowicz JS. Ultrasound and autism: association, link, or coincidence?. J Ultrasound Med 2012; 31: 1261-1269
• 11 Hoglund Carlsson L, Saltvedt S, Anderlid BM. et al. Prenatal ultrasound and childhood autism: long -term follow-up after randomized controlled trial of first vs. second-trimester ultrasound. Ultrasound Obstet Gynecol 2016; 48: 285-288
• 12 ISUOG Statement on ultrasound exposure in the first trimester and autism spectrum disorders 2016.
• 13 EFSUMB Statement on the Safe Use of Doppler Ultrasound at 11–14 Weeks (or Earlier in Pregnancy) 2018.
• 14 EFSUMB response to published study of the relationship between ultrasound exposure in the first trimester and the severity of autism spectrum disorders 2016.
• 15 Paul RosmanN, Vassar R, Doros G. et al JAMA Pediatr 2018; 172: 336-344 . doi:10.1001/jamapediatrics.2017.563
• 16 Ang ES, Gluncic V, Duque A. et al Prenatal exposure to ultrasound waves impacts neuronal migration in mice. Proc Natl Acad Sci USA 2006; 103: 12903-12910 . Epub 2006 Aug 10