3D Ultrasounds - Ultrasounds

[canuck88]

My 2 cents: For only a small amount more than the cost of these creepy 3D ultrasounds, you could hire a real photographer when baby is born and have some incredible photos done.

[nalababe]

Not necessarily true--I'm pretty sure the norm is to have two routine ultrasounds: one at around 12 weeks to check for things like ectopic pregnancy and another at around 18 weeks which they call the anatomical ultrasound. Both are covered by OHIP here in Ontario and are considered important and relatively safe from a medical standpoint. There's always going to be a risk/benefit trade-off with anything.

BTW, I completely disagree with these private imaging labs like UC Baby. Imagine getting a series of x-rays and putting them on DVD for entertainment purposes?!

FWIW, Anyone who is attending a fertility clinic (for us it was due to an abnormality in cycle hormones) will have way more than 2 ultrasounds. I think we were close to 10 the first time.

If you are at a more modern hospital/clinic, going from 2D to 3D ultra sound is simply a flick of a button on the instrument.

We have a 3D picture and I'd have no problem saying to do it? Is it worth the risk...that is a question that only you have to ask. Is one drink going to hurt the baby? Is one ultra sound? Is one sip of asparatame? To put something with so little understanding as ADD/ADHD, to make blanket statements like cause and affect is not wise.

FWIW, I'd be far more concern on a standard US using an older instrument than a 3D on a new instrument (the 3D instruments from Phillips, GE and Siemens are very new).

[nalababe]

3-D scans take longer, and provide no added medical benefit, which is why all proper labs use standard 2-D ultrasound. So if you choose 3-D, the only reason you'd be doing so is for your own entertainment, and you'd be giving baby added exposure to ultrasound energy.

No. The 3D ultrasound took the same amount of time. Exactly.

[pierrefleur]

My 2 cents: For only a small amount more than the cost of these creepy 3D ultrasounds, you could hire a real photographer when baby is born and have some incredible photos done.

I am +1 this.

[nalababe]

First, from any of the big three manufacturers (may hold for the others as well), but with the higher end models, it is the same instrument used for 2D and 3D. Since these are more expensive, sites are not just going to throw out their current systems for the newer models or are sticking to 2D only instruments.

To change from a 2D to 3D is simply a matter of flicking a switch on the instrument. It is simply more complex software to capture the information. Keep in mind that all US must keep below FDA/HC mandated levels...and older 2D instruments will subject more mW energy than a newer 3D model.

You can get the 3D-US at any time. We had ours still within the first trimester (about 10 weeks). When we were finishing a monitoring ultrasound, they just flicked the switch and we had our 3D image...it was clearly a baby in a fetal position.

Now, if you are trying to get a 4D ultrasound (with movement and video) then yes, you doing something that is not really needed.

[slim_shady]

...and older 2D instruments will subject more mW energy than a newer 3D model.

Are you guessing or can you point us to a source for this fact?

Now, if you are trying to get a 4D ultrasound (with movement and video) then yes, you doing something that is not really needed.

Very rarely are 3d ultrasounds clinically needed either, they are primarily for entertainment.

[giltron]

My wife had a 3d ultra-sound. It was a great experience. Had the immediate family come and be a part of it.

Funny thing is...since none of the ultra-sound techs at the hospital could ever seem to get a good picture of our son. We had to go for extra-ultrasounds at the hospital repeatably. Well instantly at the 3d ultrasound clinic, we had good shots and the technician easily found out my soon to be born baby was boy and all his parts were normal.

The funny thing is, if we had gone to this clinic for medical reasons sooner, my wife would have been subjected to less ultra sounds of my currently very healthy son.

[slim_shady]

The funny thing is, if we had gone to this clinic for medical reasons sooner, my wife would have been subjected to less ultra sounds of my currently very healthy son.

Not necessarily. It's mostly luck, depending on what position the baby is in at that time. It doesn't matter where you go, if the baby's face is buried in the placenta, no one will get a good ultrasound shot.

[nalababe]

Very rarely are 3d ultrasounds clinically needed either, they are primarily for entertainment.

IF you really want to get technical, 2D ultrasounds are really not necessary. Look why they are used: 1) confirm pregnancy after hcg plateau or decrease in doubling rate (we do this out of convenience), 1b) Heartbeat (don't need a US for this), 2) Nucal fold measurement (IA is just as predictive), 3) growth measurements (don't really need). It is all about convenience.

Now, with the third reason, especially when larger, it can be difficult to get accurate measurements of leg length or other measurements with 2D. With 3D we had these measurement almost instantly. Based on the principles, this makes sense. For physical abnormalities, 3D is far more useful...but yes, most people will not need these.

Finally (and for the record, I am not for these image centres) remember that US is a medical device. Outside the intended use statement, you are using the device off label, against the license. This pretty much absolves Health Canada of any responsibility if anything happens. If you can walk into an image centre and buy a 3D/4D ultrasound for the pictures, then the device is being used off label. Would you take medicine off label?

[slim_shady]

IF you really want to get technical, 2D ultrasounds are really not necessary. Look why they are used: 1) confirm pregnancy after hcg plateau or decrease in doubling rate (we do this out of convenience), 1b) Heartbeat (don't need a US for this), 2) Nucal fold measurement (IA is just as predictive), 3) growth measurements (don't really need). It is all about convenience.

Now, with the third reason, especially when larger, it can be difficult to get accurate measurements of leg length or other measurements with 2D. With 3D we had these measurement almost instantly. Based on the principles, this makes sense. For physical abnormalities, 3D is far more useful...but yes, most people will not need these.

Finally (and for the record, I am not for these image centres) remember that US is a medical device. Outside the intended use statement, you are using the device off label, against the license. This pretty much absolves Health Canada of any responsibility if anything happens. If you can walk into an image centre and buy a 3D/4D ultrasound for the pictures, then the device is being used off label. Would you take medicine off label?

Sounds like you agree with me then that 3D scans are primarily for entertainment. Too bad you missed some additional 2D clinical uses -- verifying correct funciton of heart valves, verifying placenta placement, and verifying amniotic fluid levels. Now if you could just cite your sources for your "older 2D instruments will subject more mW energy than a newer 3D model" statement we'd be all set.

(oh yeah by the way, it's not Nucal... it's Nuchal)

[rdmsgirl]

Now, with the third reason, especially when larger, it can be difficult to get accurate measurements of leg length or other measurements with 2D. With 3D we had these measurement almost instantly. Based on the principles, this makes sense. For physical abnormalities, 3D is far more useful...but yes, most people will not need these.

Difficult to get accurate measurements with 2D? Not for someone who is properly trained and with the right experience.

To those of you not the the field, please try to remember that the quality of ultrasound is mostly operator dependent - those with proper training and high standards should be able to obtain necessary images with little time and the lowest amount of exposure *
*<disclaimer - this does not apply if your baby is in a crappy position, or if the patient has a lot of extra tissue i.e fat>

[nalababe]

Difficult to get accurate measurements with 2D? Not for someone who is properly trained and with the right experience.

To those of you not the the field, please try to remember that the quality of ultrasound is mostly operator dependent - those with proper training and high standards should be able to obtain cary images with little time and the lowest amount of exposure *
*<disclaimer - this does not apply if your baby is in a crappy position, or if the patient has a lot of extra tissue i.e fat>

Yes 2D, position and orientation of the fetus can make it difficult for even the most trained operator.

Actually, quality is dependent on the 1) operator, 2) transducer and 3) software. All three play a key role. Key elements such as depth of field and resolution have changed dramatically and these are not operator dependent. As 2 and 3 are improved, the dependence on 1 decreases.

.

[powderbox]

Hi all

I just recently (last week) had my 3D ultrasound at 29 weeks and do not regret it for a second. I am thrilled that I took advantage of 5-year old technology. I went to UC Baby in Mississauga and had incredible results. The pictures were extremely clear and I don't find it creepy at all. Quite the opposite. The experience was awesome.



I would NOT recommend See3D Baby at all.

It helps if the baby is in the right position, (mine was) and we managed to get amazing images.

[nalababe]

Hi all

I just recently (last week) had my 3D ultrasound at 29 weeks and do not regret it for a second. I am thrilled that I took advantage of 5-year old technology. I went to UC Baby in Mississauga and had incredible results. The pictures were extremely clear and I don't find it creepy at all. Quite the opposite. The experience was awesome.

I would NOT recommend See3D Baby at all.

It helps if the baby is in the right position, (mine was) and we managed to get amazing images.

note: 20 year old technology (late 80's)...though the reality is that it has only been about 6 or 7 years since the put into routine use clinically (first in the States, then Canada).

[iridescent]

As a physician, I just want to clarify the "not really necessary" statements, because ultrasounds are actually very much necessary in pregnancy. For your first point, it is not really necessary to 'confirm' the pregnancy using ultrasound especially after 12-15 weeks or so, as the presumptive physical signs along with the fetal doppler heart tones are present. However, for other reasons, ultrasound is essential for the management of pregnancy. #1: Dating. A first trimester ultrasound will be accurate to within a week, and you need to see whether it's consistent with the last menstrual period dates, because if not, you have to come up with a new expected date of confinement. Why is dating so important? Say you have a woman with preterm labor, or IUGR, or some other problem. How are you going to assess what your management is going to be if your dates aren't accurate? What if you're confused about whether you're at 38 weeks vs 40 wks vs 42 weeks? Want to take a chance at post-maturity syndrome? How about whether you should tocolyze that mother with the contractions and cervical change? Furthermore, say your triple screen comes back abnormal. The most common cause of an abnormal triple screen is inaccurate dating, and the next step in the management of that is to do ultrasound, not an amniocentesis, chorionic villus sampling, etc. etc. Anyway, so the ultrasound for dating is absolutely crucial. Next, you've got to have an ultrasound for anatomy, I'd say any time in the second trimester. Third trimester ultrasounds are also extremely important as well - where's your placenta? You're not going to be able to accurately diagnose a previa or low-lying placenta early on, as the lower segment hasn't developed yet... and yet, if you're dealing with a previa by the time of delivery, you might as well be dealing with a lawsuit since you missed it before. Dangerous situation when you say 2D ultrasounds are unnecessary.

Growth measurements ARE absolutely necessary as well. How are you going to take a look at IUGR? If that baby stops growing at 28 weeks and you let it go for another 4 in the womb before you act on it, that's another major lawsuit on your hands. You bet I want to know that bpd + abdominal circumference + etc.

Anyway, as for the 'off label' part, quite a lot of things are done "off label"- as long as you have a physician who knows what they're doing and is licensed and has an understanding of what's going on + why, then it's appropriate medical practice. If you want to take an obstetric example, look at Cytotec (misoprostol) -- absolutely *NOT* FDA approved for induction of labor, yet it is used in so many hospitals appropriately for that matter. Not a big deal, as it does the job extremely well. It's a super cheap drug, so it's not lucrative enough for any pharmaceutical company to submit applications for that particular usage. The alternative is to use Cervidil (dinoprostone) suppositories at $1000+ a pop. Anyway, leave the 'off label' decisions to your physician.

Ultrasound is absolutely safe. No cause for alarm. If people want to open up 3D/4D centers and take a look at their babies, why not.

IF you really want to get technical, 2D ultrasounds are really not necessary. Look why they are used: 1) confirm pregnancy after hcg plateau or decrease in doubling rate (we do this out of convenience), 1b) Heartbeat (don't need a US for this), 2) Nucal fold measurement (IA is just as predictive), 3) growth measurements (don't really need). It is all about convenience.

Now, with the third reason, especially when larger, it can be difficult to get accurate measurements of leg length or other measurements with 2D. With 3D we had these measurement almost instantly. Based on the principles, this makes sense. For physical abnormalities, 3D is far more useful...but yes, most people will not need these.

Finally (and for the record, I am not for these image centres) remember that US is a medical device. Outside the intended use statement, you are using the device off label, against the license. This pretty much absolves Health Canada of any responsibility if anything happens. If you can walk into an image centre and buy a 3D/4D ultrasound for the pictures, then the device is being used off label. Would you take medicine off label?