FDA: Avoid Fetal ‘Keepsake’ Images, Heartbeat Monitors How Many Ultrasounds Are Too Many? BY AMANDA ROBERGE
It can be heartwarming when someone shows you their cute little fetus. That black and white fuzzy image — or more recently a sepia-toned 3D image — makes you happy to be alive in the age of technology in which stuff like that is even possible. When my babies were being incubated in the first decade of the new millennium, you would have been hard-pressed to find someone without one or more of these blurry images on their fridge. Mine got updated just about every month — my blob was growing and I had the pics to prove it. Just think! Our poor mothers had to wait until we were actually born to learn our sex and ensure we had 10 fingers, 10 toes and all of our other bits and pieces in working order. Ah, the suspense. Now, if parents don’t find out the info they were hoping for at one visit, the next one might be just around the corner. Furthermore, “keepsake” imaging centers will show you your in-utero baby for a reasonable fee. Who can forget
the media buzz when Tom Cruise shared the news of his latest toy purchase — an ultrasound machine — with Oprah Winfrey? Even in 2005, doctors were skeptical and not huge fans of Cruise’s new starring role as ultrasound tech. In addition to keepsake imaging centers, at-home Doppler and heartbeat monitors are now readily available for home use and the Federal Drug Administration has something to say about it. In a statement last month, the FDA cautioned against the use of such devices in general, citing that extended time on the skin can cause tissue damage. The warning’s language, however, was ambiguous at best and when read in its entirety, could be interpreted as targeting the at-home use of technologies moreso than those provided under the care of a trained physician or specialist. Either way, the warning is being noted by Massachusetts professionals, who have long agreed that the over-usage of imaging and heartbeat monitors has become something of a
widespread problem. “Yes, the technology is neat, but that doesn’t mean we need to be using it,” said Greenfield-based doula and childbirth educator Marissa Potter. Despite their agreement with the FDA, it was not lost on medical professionals that there was a distinct lack of peer-reviewed, evidence-based research accompanying the warning. Even so, many medical professionals agree that harmful or not, it’s time to gravitate toward a sentiment of less-is-more when it comes to ultrasound technology. "Although there is a lack of evidence of any harm due to ultrasound imaging and heartbeat monitors, prudent use of these devices by trained health care providers is important," says Shahram Vaezy, Ph.D., an FDA biomedical engineer. "Ultrasound can heat tissues slightly, and in some cases, it can also produce very small bubbles (cavitation) in some tissues." According to Potter, the medical profession’s reliance on testing
and technology is the bigger issue to which the FDA’s latest warning speaks. In our “imageobsessed” culture, she said, many of the advancements — including technologies such as ultrasound and fetal heartbeat monitors — have not served to reduce the morbidity and mortality rates like they were once thought to do. Dr. Andrew Healy, a perinatologist from Maternal Fetal Medicine at Baystate Health in Springfield, couldn’t agree more. While he works primarily with high-risk patients and relies heavily on technology like ultrasound in order to keep women and their babies safe, he errs on the side of conservatism when it comes to testing. “The bottom line is that we shouldn’t be ordering tests — ultrasound included — unless it will impact the management of a patient’s care,” he said. But Dr. Healy also acknowledges that the FDA’s warning is firmly rooted in common sense, and that while there isn’t an abundance of scientific data to support the BAYSTATEPARENT 56 57