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Adverse Effects of Doppler and Ultrasound During Pregnancy

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It is standard procedure to use a doppler to hear the baby’s heartbeat during every prenatal appointment with your doctor. It is also standard to have at least one ultrasound during pregnancy to determine the baby’s development. The question we should be asking is should we be using doppler and ultrasound as standard procedure during pregnancy?

There are many reasons people opt to get ultrasounds:

  • Find out the sex of the baby
  • Determine the due date
  • See your baby
  • Check the heartbeat
  • Check for multiple pregnancies
  • Check for congenital abnormalities or birth defects
  • Monitor the baby’s growth and position
  • Look at the placenta to check for problems

Many of these are great benefits of getting an ultrasound. Nevertheless, there are also risks. We need to weigh each of them to see if the benefits outweigh the risks.

Heat

Ultrasound and doppler ultrasound generate heat. Safe body temperature increases in pregnant women are up to 4.5 degrees F. Research shows that doppler ultrasound can cause significant heating. It can raise temperatures from 2.5 to 10.4 degrees F, which is beyond the level that is believed to be safe.

Possible Autism Risk

In a US study, there is speculation that ultrasound in the first trimester of pregnancy may contribute to autism. The thought is that exposure early in pregnancy could disturb brain development and alter behavior. This is especially for people who are genetically predisposed to autism.

Miscarriage and Preterm Birth

A Helsinki study showed an increased risk in miscarriages for women who received ultrasound between sixteen to twenty weeks in comparison to women who did not receive scans.

In a Michigan study, women at risk for giving premature birth were studied. One group received weekly ultrasound scans. The other group received pelvic exams. In the ultrasound group, women went into preterm labor at 52%. Only 25% of the control group went into preterm labor.

Ultrasounds Do NOT Improve Fetal Outcomes

First of all, ultrasounds are not 100% accurate at determining the development and health of your baby. There are many times the results of an ultrasound have been wrong. This is especially unfortunate for moms and dads who may be emotionally distraught at being told their baby has serious defects.

One study found that fetal outcomes were not improved for women who had an early diagnosis of placenta praevia. 250 women were diagnosed with placenta praevia out of 4,000 women scanned in the study. They were given scans between sixteen to twenty weeks. Once delivery occurred, only four women had placenta praevia. There were also 4 women in the unscanned group who were diagnosed with placenta praevia. All the women received caesarean sections and there were no improved outcomes in the babies.

In an Ohio study, babies with serious defects were studied. Some of the defects included diaphragmatic hernias, abdominal wall defects, meningomyelocele and bladder extrophy. Only 36% of the defects were found before birth. The women received between one to fourteen scans each, with an average of five scans. 3 babies out of 13 who were diagnosed before birth died. There was a only one death in the 23 babies who were undiagnosed. All babies who were diagnosed in utero were delivered by c-section. In addition, 19 of the 23 babies who were undiagnosed had safe, uncomplicated vaginal deliveries. There were lower birth weights in the diagnosed babies. They also were in utero 2 weeks less on average. The outcomes were the same in the diagnosed and undiagnosed groups.

Sadly, more babies died in the diagnosed group despite knowing about the defects in advance. In this case especially, outcomes were not improved.

A German study studies babies with growth retardation. Babies were found to be small on an ultrasound had a 44.3% chance of being delivered by c-section versus 17.4% for babies who were not diagnosed as small. Babies diagnosed with intrauterine growth retardation (IUGR) were pre-term five times more than those were not diagnosed. Pregnancies were 2 to 3 weeks shorter than than for an undiagnosed one. For babies diagnosed with IUGR, the admission rate was 3 times higher for intensive care.

My assessment in all of these cases is that doctors and patients were trying to take precautions by giving pregnant mothers extra ultrasound scans, which resulted many times in early delivery and c-sections, which may have been unnecessary. The research suggests that more babies would have survived if less interventions were taken.

My Recommendations

If you want to use doppler and/or ultrasound to check on the baby, use it less often, or just use it once to check on the baby’s health and development. An alternative to using doppler is a fetoscope. My doctor does not use fetoscopes in his practice, so I purchase one that I bring in to every appointment. It is around $10, so it won’t break the bank. The downside is you won’t be able to hear the baby’s heartbeat until you are around 20 weeks gestation.

If there are no concerns about the baby and you can be patient, it is worth it to wait until 20 weeks to hear the heartbeat. The best reason to wait is there won’t be any adverse effects to the baby from using a fetoscope to listen to the heartbeat.

I believe if you are eating an optimal diet before and during pregnancy and you are in overall good health, there is a low risk that anything would be wrong with the baby. Check out my dietary and supplement recommendations during pregnancy.

There is no alternative to ultrasound, but ultrasounds are less harmful than doppler because they use less levels of ultrasound. My recommendation is to avoid getting an ultrasound unless the doctor suspects something is wrong with the baby.

If you absolutely want to have an ultrasound, just get one around 22 weeks to check on the baby’s development. Tell the sonographer to only show you what is necessary. We didn’t find out the sex of our baby, so that saved a little time. We also declined extra pictures, which can take more time. We did get to keep 2 pictures she captured at the end! She told us that was the fastest she had ever performed an ultrasound!

Finally, do NOT get a 3-D or 4-D ultrasound! The FDA says that ultrasounds should only be performed for medical reasons and by licensed staff and they should not be used for emotional reasons.

What did you do during your pregnancies?

Adverse Effects of Doppler and Ultrasound Pinterest

6 comments

  1. Kristen says:

    Yes!! I decided years ago that I didn’t want ultrasounds and I was looking for a summary of why to send to my husband. If he insists on getting one, it will just be ONE and later in the pregnancy. Forwarding this to him now!! (this is Kristen from the WOC women’s group)

    • Sarah says:

      Hey Kristen!! I’m so glad this is helpful for you. I mostly had them listen to the heartbeat via the fetoscope, but I did have them use the doppler a couple times (one of the doctors didn’t know how to use it and another time I forgot) and a bunch during labor since that was hospital policy. Ugh. If you can help it, try to just opt for the fetoscope since doppler is worse than ultrasound.

  2. Mosann says:

    This overview is problematic for a few reasons.

    First, just as it’s misleading to report on studies that have only reported a technology to be safe, it is disingenuous to report only studies that suggest a risk. This would be like reporting on the handful of climate papers that didn’t find a climate change trend, and excluding the vast majority of papers that found evidence of climate change. Evidenced-based decisions need to be based on *all* of the evidence.

    Second, it’s similarly misleading to only cite studies that are from 1990-1999, and exclude more recent data. Only the autism study is from 2016, and that was not a randomized control trial. The ultrasound technology, the way it’s applied, and the interventions available are all different. Doctors don’t administer weekly ultrasounds, as in the Michigan study from 1990 you refer to. Today, Houston is doing in-utero surgery for spina bifida. UCSF does fetal heart surgery. Several hospitals do surgery at birth for abdominal wall defects (organs outside the body). Not all babies can be saved, but there are babies who can benefit from early diagnosis in a way they couldn’t in the ’90’s, and discouraging those parents from seeking those diagnoses and interventions may cost lives.

    Third, the descriptions–which I understand you took from the 1999 midwifery article–of the Ohio study and the German IUGR study confuse correlation with causation. With those early technologies, it’s likely that the only the more severe birth defects/cases of IUGR could be diagnosed via ultrasound. So it stands to reason that those babies would have more adverse outcomes. But that doesn’t mean that (1) the ultrasound caused those outcomes.

    The authors of the autism study themselves write that other studies of ultrasound exposure showed “no significant (or consistent) relation to congenital anomalies, birth size, cancer/tumors, heart disease, general neonatal and child outcomes, and specific psychopathology such as schizophrenia and psychosis”. There is little to lose and a lot potentially to be gained from judicious use of today’s ultrasound technology. Please be more responsible in your “reporting.”

    • Sarah says:

      Hi Mosann,

      I don’t believe it is problematic because I titled the article “Adverse Effects of Doppler and Ultrasound During Pregnancy”. Most people are going to get at least one ultrasound during their pregnancies because they think they are supposed to, don’t think twice about it, simply want to find out the gender of their child or they want peace of mind. I am definitely not against people making their own decisions or following their doctor’s advice if their doctor believes it is necessary to check on a problem or even check to see if there is a heartbeat. Most people are unaware that there are risks for receiving ultrasounds while pregnant, so that is the main reason I wrote this article. Many people are aware of the benefits, so I didn’t think it was necessary to point those out.

      Yes, some of the studies are from the 90s, but ultrasounds are now 7 times stronger, so I wonder if there are additional risks now?

      I tend to go by the precautiounary principle, which states “When an activity raises threats of harm to the environment or human health, precautionary measures should be taken even if some cause and effect relationships are not fully established scientifically.” This is a principle I go by a lot when writing and teaching others as well as in practice in my own life. One example are X-rays during pregnancy. Yes, ultrasounds are based on non-ionizing radation. However, my point is that doctors used to believe X-rays were safe to use during pregnancy and now they know they aren’t. Until studies can show better safety on ultrasounds during pregnancy, I am going to recommend people, including myself, to think twice about getting them or limit them to one if possible.

      Even the FDA states this on their website about ultrasounds during pregnancy: “Although ultrasound imaging is generally considered safe when used prudently by appropriately trained health care providers, ultrasound energy has the potential to produce biological effects on the body. Ultrasound waves can heat the tissues slightly. In some cases, it can also produce small pockets of gas in body fluids or tissues (cavitation). The long-term consequences of these effects are still unknown. Because of the particular concern for effects on the fetus, organizations such as the American Institute of Ultrasound in Medicine have advocated prudent use of ultrasound imaging in pregnancy. Furthermore, the use of ultrasound solely for non-medical purposes such as obtaining fetal ‘keepsake’ videos has been discouraged. Keepsake images or videos are reasonable if they are produced during a medically-indicated exam, and if no additional exposure is required.”

  3. Alex R. says:

    With my first I had two maybe three and of course doctors don’t give full disclosure of anything…meaning most are not making truly informed choices. After the doctor nearly killed my baby I became obsessed with all things birth. I educated my self for years before having my next child. Since I now do all of my own prenatal care I have had zero US or Doppler with my last two babies(family births/Freebirths). Yeah, I know it’s radical and I don’t expect most to go that route but it’s right for my family. I have a fetoscope which is really just for fun.
    Hope people start to realize the over use; and that more regulations are placed on the use of these tools. Sadly doctors count on this technology to the extent they wouldn’t know what to do for prenatal care without it. My Hope is we can find balance for the sake of the human race. Science is slowly catching up with the fact less tech in pregnancy and birth is best…something women/midwives have known.

    • Sarah says:

      Hi Alex – thanks for sharing your experience here. Wow! That is very different than most births, but that is great you were able to do it safely. They are definitely over used. My doctor thankfully only has one recommended ultrasound per pregnancy, which is always optional. However, in my last pregnancy, I opted for a birth center and one ultrasound is mandatory if you do not want to birth in the hospital. You definitely have to be your own advocate and speak up if you want things to go differently.

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