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Destructive curiosity

MagazineSeptember 1993 (Vol. 4 Issue 6)Destructive curiosity

In mid July, some sobering news emerged about ultrasound scanning

In mid July, some sobering news emerged about ultrasound scanning. According to a Norwegian study of 2,000 babies performed by the National Centre for Foetal Medicine in Trondheim, those subjected to routine ultrasound scanning were a quarter less

What rated only secondary mention in the press was the astounding conclusion by two researchers in Switzerland in the BMJ a few weeks before (3 July 1993). The researchers did an analysis of all the scentific (ie, randomized, controlled) studies of ultrasound scanning to evaluate its effect on the outcome of pregnancy.

Their conclusion: ultrasound doesn't make one bit of difference to the ultimate health of the baby. My obstetrician rightly argues that ultrasound helps in detecting multiple births and confirms suspicions of placenta previa (potentially fatal low lying placenta). But it doesn't improve the live birth rate or help to produce fewer problem babies.

One reason it makes no difference in terms of live births is that the babies who are usually aborted after a scan shows up a severe malformation are usually those who would have died shortly after birth anyway.

The only reason for its use, the researchers concluded, was to screen for gross congenital malformations not to ensure your baby is "all right", the usual vague rationale offered to every modern pregnant woman with no suspicious symptoms. And even using scans for screening isn't without its risks since 2.4 per 1000 women, according to one study they looked at, will be given a false diagnosis of a malformed fetus.

Put all this together, say the Swiss doctors and you come up with a risk benefit equation that doesn't pan out: "Though routine ultrasound scanning does not improve the outcome of pregnancy, it exposes pregnant women to the risk of false diagnosis of malformations." Not to mention possible brain damage to the baby.

This means the only advantage of scanning most uneventful pregnancies is to satisfy our curiosity, to try to get a little closer to the mystery of life.

Somebody I know had personal experience with this a few weeks ago when she experienced some bleeding in early pregnancy. Her obstetrician urged her to have a scan to save her undue anguish. She thought about what a scan was going to do for her. The scan wouldn't prevent a miscarriage. It couldn't save anybody's life. It might tell her the baby was alive or dead a few weeks earlier than her body would have. What sort of anguish saving activity would it be to know she was carrying around a dead baby? And what if the scan got it wrong? What good was this technology in a genuine hour of need?

In the end she declined her doctor's offer. A few days later, her own bodily intuition assured her that everything was back on course. It heard a heartbeat that was louder and clearer than any machine has yet been able to detect.


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