WSJ: Fetal ultrasound procedures are often not medically justified

The use of the most common fetal-ultrasound procedures averaged 5.2 per delivery in 2014, up 92% from 2004, according to an analysis of data compiled for The Wall Street Journal by nonprofit insurance claims aggregator FAIR Health.  However, some experts in the field are saying the scans are not medically justified, especially in light of the upswing in procedures with the devices.  Last year, medical societies including the American College of Obstetricians and Gynecologists said low-risk, complication-free pregnancies should only have one or two ultrasounds, according to the WSJ article.  And about 80% of pregnancies are low-risk, the newspaper notes, signaling a possible disparity between who is and should be getting the procedure.

“The message needs to be gotten out,” Phillip Bendick, an ultrasound scientist and editor of the Journal of Diagnostic Medical Sonography, told the WSJ.  “The public needs to be made aware that if you’re pregnant, you don’t drink alcohol, you don’t smoke and you don’t need to have an ultrasound at every doctor’s visit.”  Part of the issue could be the lack of knowledge surrounding fetal ultrasounds.  Most of the research examining fetal ultrasound equipment’s safety was done in 1992, when the procedure was used less frequently and produced less acoustic energy, the WSJ notes.  And some doctors think ultrasound is inherently safe because it doesn’t deliver any carcinogenic radiation, Wayne State University obstetrician Dr. Jacques Abramowicz told the newspaper.  “They think, ‘It’s not X-ray. It’s safe. Period,” he said.

The procedure still has its benefits, offering accurate estimates of when conception began and helping doctors make decisions during pregnancy like when to induce labor.  Especially in high-risk pregnancies, fetal ultrasounds are useful as they can identify multiple fetuses and detect potential abnormalities, according to the WSJ article.

Still, the method is not foolproof.  Fetal ultrasounds often yield false positives, and some physicians end up delivering infants by cesarean section based on the data rather than opting for traditional–and less risky–birth.  “If you go looking for trouble, you will find it,” Dr. Jeffrey Kuller, a Duke University obstetrics professor and practicing doctor, told the newspaper.

REFERENCE:  Fierce Medical Devices; 17 JUL 2015; Emily Wasserman

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