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New radiation protection regulation: Ultrasound in pregnancy is restricted
Health experts criticize that there are too many harmful unnecessary checkups during pregnancy. Some people think that ultrasound scans can harm the unborn child. But experts point out that this is not the case.
Ultrasound examinations during pregnancy in the criticism
The new Radiation Protection Ordinance came into force on January 1, 2019. Among other things, this also includes the use of ultrasound in pregnancy. Accordingly, this is prohibited from the end of 2020 in non-medical contexts - such as for the implementation of the so-called "baby TV". The German Society for Ultrasound in Medicine e.V. (DEGUM) confirms that sonography for diagnostic purposes is only carried out by doctors in this country and should be clearly distinguished from commercial "baby watching". However, because the method - 3D ultrasound - is the same, ultrasound examinations during pregnancy have generally come under criticism. DEGUM rejects this.
No health burden for the unborn
"Despite decades of intensive research, there are still no study results that indicate that ultrasound examinations during pregnancy pose any health problems for the unborn child," said PD Dr. med. Kai-Sven Heling, Vice President of DEGUM in a message.
Current studies have shown that a theoretical, ultrasound-related temperature increase in the body of the pregnant woman - which could be regarded as a potential hazard - is significantly below the temperature rise that is triggered by fever or strong physical activity.
The use of 3D ultrasound in the context of prenatal care is therefore generally harmless.
Only if the so-called PW Doppler ultrasound is used - which, according to the experts, occurs very rarely and is the case, for example, when researching the causes of known growth disorders - could prolonged use lead to a temperature increase in the mother's body.
"However, PW ultrasound would only be potentially harmful to the fetus if it were used continuously for several minutes," said Heling.
Potential risk must be dismissed out of hand
Because this special mode for blood flow measurement is usually only used for a few seconds and the examiner is continuously shown the expected temperature increase, this potential risk must also be dismissed.
When this Doppler examination is carried out, the fetus is only very rarely detected by the transmitted sound signals.
"In most cases, only vessels that lie outside the fetus are examined - such as the maternal uterine arteries or the blood vessels of the umbilical cord," explained DEGUM expert Professor Dr. Peter Kozlowski.
Only in the case of very specific questions would fetal vessels be examined directly, for example in the liver or lungs.
And only in very few exceptional cases - with a clear indication - would the fetal brain be examined. The principles mentioned regarding the duration of the investigation would also be taken into account here.
Presumed association with autism
And even if the fetal skull is detected during ultrasound examinations, no damage is caused according to current knowledge.
“The connection between the use of ultrasound in unborn babies and later autism, which some researchers in the USA have assumed, is based solely on the observation that the incidence of autism has increased in roughly the same way as the number of ultrasound examinations in recent decades “, Says Heiko Dudwiesus, head of the DEGUM ultrasound systems working group.
Some other research groups now contradict this thesis and point out that the number of radiation-intensive means of communication - for example due to the increased use of mobile devices - has increased over the same period.
Furthermore, a study based on 211 children with developmental disabilities (including 107 autism cases) showed that they had not been examined more often or more intensively by ultrasound during pregnancy than children without developmental disorders.
In addition, the current study situation does not indicate that ultrasound applications during pregnancy can cause cell changes or cell damage in the fetus.
DEGUM rejects current criticism
"Since laboratory tests have shown that gas bubbles generated by ultrasound are only created by enriching the blood with foreign material - such as contrast media - but this is not used in ultrasound examinations during pregnancy, this potential hazard can also be excluded," said Dudwiesus.
On the basis of this extensive study knowledge, DEGUM vehemently rejects the current criticism of ultrasound examinations using 3D methods in pregnancy.
"One can be critical of the so-called" baby television "for commercial purposes, because - among other things because of often unskilled users - there is a real risk of not recognizing actual problems with the fetus," says Heling.
"But we fully support the use of ultrasound for diagnostic purposes."
The statement in the new radiation protection regulation, according to which the fetus could be endangered by ultrasound, is therefore incorrect. If the legislature wanted to ban "baby television", a different approach would have to be taken.
According to the current maternity guidelines, every woman in Germany can take three funded ultrasound examinations during pregnancy, explains DEGUM.
Further investigations are advisable in the event of abnormalities or existing risks. In order to largely rule out early childhood malformations, there is also the option of having so-called diagnostic tests carried out at your own expense.
This includes, for example, early organ diagnostics between the 11th and 13th and fine diagnostics around the 20th week of pregnancy, in which the vast majority of child malformations can already be recognized or largely excluded.
Anyone who “does not have to wait until the scheduled dates and“ just have a look ”, or who would like to receive a more elaborate procedure, has to do these ultrasound examinations, which are colloquially known as“ baby television ”, as individual health services (IGeL) Pay out of pocket, is explained on the website "IGeL-Monitor".
"Depending on the procedure, an examination usually costs between 20 and 200 euros," it says. (ad)