20 August 2007

Uganda: How Safe is Your Baby With Ultrasound Scan?

Kampala — SARAH Simiyu, a mother of five girls, is the second of the four wives of Masaba, a butcher in Nakalooke village, Mbale.

Simiyu is now two months pregnant and, like most women in polygamous marriages, she is desperate to have a baby boy, to be able to get a share of her husband's property.

During one of her antenatal visits, Simiyu was advised to go for an ultrasound scan to determine the sex of her unborn baby, but she could not raise the required sh50,000. She is now saving every coin she gets and is determined to go for the scan on her next antenatal visit. Hopefully, the results will bring a smile smile to her face.

The world over, obstetricians offer routine ultrasound scan during pregnancy, which are now regarded as an integral part of antenatal care. Pregnant women are thronging clinics to get a first glimpse of their babies in the womb. But does any of them ever stop to think of the effects this technology could have on their unborn babies?

Dr Iga Matovu, a senior radiologist at Mulago Hospital, says unlike x-rays which use ionized radiation, ultrasound scans, use high frequency sound waves to reveal features inside the body, which makes the procedure safe for both the mother and her unborn child. The ultrasound waves from the scanner pass through the body, are reflected back, analysed by the computer and displayed as image on the monitor. The radiologist then interprets an image.

"It is a useful tool for assessing the position and condition of the unborn baby. It also allows parents a peek at their unborn child," Matovu says.

Dan Kigozi, a radiographer at Abii Clinic, says ultrasound scans help detect abnormalities and conditions in both the unborn baby and the mother.

He says there is no recommended number of ultrasound scans that should be performed during routine antenatal care because ultrasound has no known side effects. However, he adds that ultrasound should only be performed under medical recommendation and by qualified medical personnel.

"Many healthy pregnancies will not require any ultrasound but many mothers get fascinated by looking at their babies in the womb." But, despite all the sweet melodies we hear in praise of the technology, research findings are beginning to emerge with facts that cast doubt on the safety of the ultrasound scan.

Dr Darrel Crain, natural health writer in San Diego, writes in Planet Chiropractic News: "Parents might suppose the reason their baby is seen twisting, flexing, and opening and closing its mouth during the ultrasound video is because the baby realises, 'It's show time!' Research, however, has shown that these active motions, which always begin as soon as the ultrasound is switched on are a desperate attempt by the baby to get out of the way of the penetrating beam.

According to Mayo Foundation researcher, Dr Mostafa Fatemi, babies experience ultrasound as an intensely loud sound, "equivalent to the level of sound produced by an approaching subway train."

Dr Matovu says that one of the most popular non-medical uses of ultrasound scans is to determine the sex of the baby.

"We discourage this because it has some adverse psychological implications," he says. "Imagine a mother who has five daughters and is desperately in need of a baby boy. Such a mother can easily carry out an abortion if she finds out she is carrying another baby girl," Matovu says.

The mother can suffer stress, which can result in serious problems such as a miscarriage or premature birth.

In India, the rampant misuse of ultrasound scans to determine the sex of an unborn child with the aim of performing sex-selective abortions of female foetuses prompted the enactment of the Prenatal Diagnostic Techniques (Regulation and Prevention of Misuse) Act 1994. Under this Act anyone running a diagnostic unit for sex-selection, those who perform the sex-selection test, anyone who advertises sex selection, mediators who refers pregnant women to the test could be charged.

Diagnosis of fetal abnormality can be devastating to the parents. It can cause anxiety, unnecessary panic, increased caesarean births, and fewer babies carried to full-term. Moreover, these abnormalities could be false.

Kigozi says if used by unprofessional people, an ultrasound scan can give false results, causing unwarranted fear and anxiety. The impact of false results can adversely affect the mother.

Any possible harm to the baby?

-Cell damage

Kigozi says there are potential dangers if ultrasound scan is not properly used. Ultrasound heats body tissues creating temperature changes. This may cause damage to the human cells.

-Brain damage

Research findings suggest that ultrasound scans on pregnant women may cause brain damage in their unborn babies. Doctors have found that men born to mothers who underwent scanning were more likely to show signs of subtle brain damage.

Kigozi says surprisingly, after nearly 50 years of use (and with almost universal acceptance), there is still insufficient comprehensive research available that can truly evaluate the effects of ultrasound exposure on pregnancies and unborn babies.

"This makes it difficult to draw reliable conclusions about their safety or to create clear guidelines for its responsible use.

"At this stage, most reports conclude that there are no obvious adverse effects, but stress the need for further research," he says.

To go or not to go for ultrasound, the ball remains in your hands.

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