European Stars and Stripes (Newspaper) - December 18, 1990, Darmstadt, Hesse                                Viewing the womb ultrasound imaging helps manage pregnancy by Jane e. Brody new York times n my eighth month of pregnancy in 1969, my obstetrician ordered an abdominal a Ray to confirm his suspicion that i was having twins although i feared possible fetal harm from the radiation i knew the information the a Ray would reveal could be very important  Way the rest of my pregnancy was managed to assure my babies Well being. No such risk need be taken now and women do not have to wait until late in pregnancy or until delivery to find out they. Are having More than one baby. Today ultrasound imaging a diagnostic technique that uses High Energy sound. Waves produces a very detailed View inside the womb without exposing woman or fetus to the risks of radiation. A. Ultrasonography a crude experimental technique when my sons were born is now a widely available highly developed technology that can reveal information vital to the management of. A pregnancy. In some obstetrical practices son Graphy has become a routine part of prenatal care and a growing number of obstetricians have ultrasound machines in their offices in a study published last summer in the lancet a British medical journal physicians ,. From Helsinki Finland described results from a study of 9,300 pregnant women half of whom underwent routine son Graphy from the 16 the to the 20th weeks of gestation. Although Many of the women in the control group also had sonograms at various stages of pregnancy in the group that was. Systematically screened Only half As Many babies died near the time of birth. The searchers said the routine examination helped to prevent premature deliveries Haemorrhaging from a misplaced Placenta and the birth of severely malformed infants since Many women found to be carrying deformed fetuses chose to have an abortion. Moreover women who had screening son Graphy made fewer prenatal visits presumably because they had fewer a complications. Use of son Graphy in pregnancy without a Good medical reason is still frowned upon by experts in this country. Nonetheless Well Over half of pregnant. Women now undergo one or More ultrasound examinations usually to answer questions that can affect the course of. Obstetrical care a a a in addition to counting the number of fetuses Early in pregnancy physicians can use ultrasound to determine a woman s due Dale Check for fetal anomalies Monitor fetal growth assess the health of the tissues that support the pregnancy and. Sometimes determine the cause of complications a All without a single. Incision or insertion of an instrument. My sister in Law was a recent beneficiary of this remarkable tool. Near the end of her sixth month of pregnancy she began to bleed and had contractions. A Sonogram revealed that the Placenta had partly torn from its moorings and was in the wrong place Complete bed rest was prescribed. After another Sonogram eight not Over half of pregnant women in the United states now undergo one or More ultrasound examinations Here a nurse at the University of Washington medical Center in Seattle reads a continuous electronic recording of the heartbeat of a patients unborn child. Weeks later she was assured that the fetus was developing normally. A. \ there was no reason to deliver the baby Early her doctor said. Two weeks before her due Date she went into labor spontaneously and gave birth to a healthy boy. In an ultrasound examination a microphone Steed transducer emitting High Energy sound Waves scans the womb from the surface of the Abdomen. The different ways in which various tissues reflect these sound Waves is picked up by the instrument and converted into a picture of the fetus Placenta and amniotic fluid showing details As tiny As a fetal Eye. In the most recent innovation a transducer is inserted through the Vagina to scan the uterus directly enabling physicians to see details As Small As 1 or 2 Millimetres. A a a. A this permits them to diagnosis pregnancy or complications within a Day or two of a missed menstrual period. Ultrasound can be used to estimate the age of the fetus when the woman is Uncertain about when she conceived when the size of the uterus does not match the presumed stage of gestation or when a woman is to undergo a scheduled caesarean delivery or induction of labor. Such dating decreases the risk of an inadvertent premature delivery. Sometimes when a prenatal blood test Quot suggests a problem of fetal development ultrasound is used to be sure the woman is co erect Abou 11 h e stage of p Regn Ancy \ which influences the test results. Ultrasound allows physicians to make frequent checks on fetal growth and development when for example the woman has kidney disease diabetes or severe hypertension,.which Cap result in insufficient a nourishment for the fetus. A a a. A  toward the end of pregnancy son Graphy can detect intrauterine growth retardation fetal movements fetal breathing and heart rate patterns helping the physician decide whether to deliver the baby Early or treat it in the womb. A a when a feta abnormality is detected an the decision is made to continue the a 1 pregnancy ultrasound can be used to m Onito r be Taf Deve to p ment a and serve As a guide to prenatal and postnatal treatment. When parents have months to prepare mentally and physically for a problem at birth they a re Bette r Able to m Ake rat ional decisions about treatment Asfa r As c an be Scie it i focal by established nothing untoward has happened to any child As a result of undergoing one or More ultrasound exams while in the womb. Nonetheless the 14-member panel agreed that routine Ultrasonography is not n of recon me need. The panel especially frowned upon frivolous use of the technique for example to satisfy parental curiosity about the baby s sex. One of the most comprehensive assessments of the Short term and Long term effects of prenatal son Graphy involved nearly 20,000 pregnancies among women in Canada. A a a the cd Dren born to these women have so. Far been followed for up to 15 years and no a untoward effects have been selected. A when children who had been exposed to ultrasound before birth were compared with those who had no such exposure no. Differences could be found in their rate of g growth b r Dove i o pm e it s a id d r. Edward a \ Lyons of the University of Manitoba health science Center. A. A. \ a a in addition studies of hundreds of children with cancer in England showed no relationship Between occurrence of the disease and intrauterine exposure to ultrasound a a a a a a while no ill effects on future health an development have yet been detected the experts convened by the National institutes a of health cautioned against assuming that a ultrasound in perfectly Safe. A. A a they and others Point to Laboratory studies a showing damage to cells from High Energy. Sound Waves and to studies in Laboratory a animals in which ultrasound exposure in a Quot  hearing damage and other ill effects in the offspring. A. A a Quot until such matters Are resolved pregnant women would be Wise to inquire about the. A potential value of a Sonogram and whether the person doing the exam has been thoroughly trained and uses up to Date. Equipment. Y lip july. No g1 p0 a Sonogram of the head and upper Torso ots human fetus at 26 weeks. Not m Page 16 the stars and stripes tuesday december 18, 1590