Picture This

New 3-D and 4-D ultrasound pictures delight parents-to-be, but some in the medical field don't have such a rosy view.

April 01, 2005|By Karen Blum | Karen Blum,SPECIAL TO THE SUN

On a recent Monday, Tim Brophy and his pregnant wife, Suzanne, went to Little Sprout Imaging in Towson for a sophisticated type of ultrasound, though it wasn't a procedure her doctor had ordered.

The Forest Hill couple, along with his mother and sister, were escorted into Little Sprout's living room-like environment, decorated in rich green tones, where Tim settled into an overstuffed armchair next to the examination table and his mother and sister relaxed on a plush sofa a few feet away.

For the next half-hour on two flat-screen monitors, the family watched little Gavin, due April 14, lick his hands, stick out his tongue and otherwise wriggle around as his escapades were recorded on a DVD and videotape.

While Celine Dion music played quietly, the Brophys studied Gavin in full detail, admiring his fingers and facial features, and concluding that he resembles soon-to-be-older-brother Garrett, age 6.

"I feel like we're right in your stomach with you," Ginny Brophy teased her daughter-in-law.

The Brophys are one of a growing number of couples taking advantage of three- and four-dimensional ultrasound - technology that offers clearer pictures of the fetus than its traditional two-dimensional counterpart. In the process, it has transformed the routine sonogram into an entertainment vehicle, raising some concern in the medical community.

At least 120 fetal-portrait studios are in business across the country, some in shopping malls, according to Little Sprout owner Martha Morgan. Though 3-D and 4-D ultrasound imaging is generally not medically necessary or covered by insurance, expectant parents are paying about $300 on average for the experience.

Little Sprout opened in October, and business has been steadily increasing. The imaging center now has about 50 clients a month, some coming from as far away as Delaware, Northern Virginia and Pennsylvania. Another Maryland studio, Baby Insight of Potomac, opened about two years ago and has 150 to 200 clients each month, according to owner Matt Evans.

Tim Brophy, 29, heard about 4-D ultrasound through a neighbor and a co-worker who each had it done. He searched the Internet and found Little Sprout's Web site.

Besides the DVD and videotape, the Brophys went home with 8x10, 4x6 and wallet-size photos and a CD of the images, all wrapped in peach tissue paper and placed in a bright green gift bag with the Little Sprout logo. They've since showed the videos to family members, and Brophy is posting the photos on a Web site that out-of-town relatives can access.

"It was completely worth it for what you're getting," he said. "It's hard to put a price on seeing your kid before he's out."

FDA has reservations

Not everyone shares his sentiments. The U.S. Food and Drug Administration considers the use of ultrasound to produce fetal keepsake videos to be an unapproved use of a medical device. The images may be made by people not well trained, the FDA cautions, or for longer exposure times than are usually used in medical situations. The agency also is concerned that women might mistake fetal portrait ultrasound for a medical examination.

These arguments are supported by other industry groups, including the American Institute of Ultrasound in Medicine and the American College of Radiology.

Dr. Carol Rumack, chairwoman of the American College of Radiology's Commission on Ultrasound and a professor of radiology at the University of Colorado School of Medicine, said her main complaint is that fetal-portrait studios do not present a written report, as is customary after traditional diagnostic imaging studies.

Morgan and Evans counter that they employ only licensed ultrasound technicians, called sonographers, and have clients sign waivers stating that they understand the 4-D session is not a substitute for obstetrical care. In two cases where a Little Sprout sonographer observed an anomaly during a scan, Morgan said, the clients' doctors were notified.

Evans added, "In more than 300 medical studies, ultrasound has never been shown to be harmful to the mother, baby or operator."

(Although ultrasound is generally considered safe, if it is done for long periods of time or at a high frequency, there may be some risk of heating the mother's body, which could potentially harm the fetus. Medical studies on the overall safety of ultrasound, however, have been inconclusive so far.)

Nearly all women have at least one ultrasound exam, also called sonograms, during the course of their pregnancy to determine fetal growth and position, and to check for birth defects. The technology, similar to sonar, uses high-frequency sound waves to produce images of organs or tissues inside the body.

In two-dimensional ultrasound, a probe placed on the belly sends sound waves into the body. As the waves bounce back, a computer in the ultrasound machine interprets the distance to tissue, as well as the tissue's size, shape and consistency, then turns that information into black-and-white outlines of the baby, seen on the monitor.

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