You’ve probably already experienced a 2D (two-dimensional) ultrasound and know it can be an exciting and magical moment. A transducer is placed on your belly or into your vagina to send sound waves through your body. The waves bounce off internal organs and fluids, and a computer converts these echoes into a two-dimensional image (or a cross-sectional view) of the fetus on a screen.
With Doppler fetal ultrasound, your practitioner uses a hand-held ultrasound device to amplify the sound of the fetal heartbeat with the help of a special jelly on your belly.
For 3D ultrasounds, multiple two-dimensional images are taken at various angles and then pieced together to form a three-dimensional rendering. For instance, instead of just seeing a profile view of your baby's face, you can see the whole surface in a 3D sonogram (it looks more like a regular photo).
A 4D ultrasound is similar to a 3D ultrasound, but the image shows movement. That means like a video, in a 4D sonogram you see your baby doing things in real-time (like opening and closing your eyes and sucking your thumb).
There are many reasons ultrasounds in general are necessary during pregnancy, depending on the trimester, including:
Medical practitioners use 2D and Doppler ultrasounds in uncomplicated pregnancies to examine the fetus, assess amniotic fluid and look for birth defects, among other reasons. Ultrasounds in 3D and 4D are performed only to closely examine suspected fetal anomalies, such as cleft lip and spinal cord issues, or to monitor something specific. In other words, 3D sonograms and 4D ultrasounds are not part of routine prenatal exams.
Studies evaluating the safety of ultrasound technology show mixed results. At this point, the American Congress of Obstetricians and Gynecologists (ACOG) says that while there are no known risks of ultrasounds for pregnant women, they should be used carefully and only for medical purposes. According to the Food and Drug Administration (FDA), when ultrasound enters the body it heats the tissues slightly, which in some cases can create small pockets of gas in body fluids or tissues and that the long-term effects of this are unknown.
Given what we do know, experts (including ACOG and the FDA) say that ultrasounds should only be performed by a qualified medical professional when your practitioner deems them necessary for medical reasons. Currently, ACOG recommends that expecting women have at least one 2D ultrasound between weeks 18 to 22 of pregnancy, noting that some women may also have a first-trimester ultrasound.
Experts also discourage the use of any kinds of ultrasounds (2D, Doppler, 3D and 4D) for the purpose of creating a memento. That's because, in addition to potentially putting your baby’s health at risk, the technicians who perform commercial ultrasounds may not be able to address your questions and likely won’t have the expertise to be able to spot any problems with your baby’s development. What's more, some sessions last for 45 minutes — much longer than a medical scan. A long session (or repeat sessions, as some of these centers offer) can be intrusive and disruptive for a fetus who's using womb time to grow, develop and get the sleep he needs.
The same thinking goes for at-home Doppler ultrasound machines, which aren't nearly sensitive enough to pick up on fetal heartbeats until the fifth month of pregnancy (and the FDA requires a prescription to use them).
Remember: There will be plenty of opportunities to take photos and make memories when your baby is born. In the meantime, keep ultrasounds to a minimum.
Health information on this site is based on peer-reviewed medical journals and highly respected health organizations and institutions including ACOG (American College of Obstetricians and Gynecologists), CDC (Centers for Disease Control and Prevention) and AAP (American Academy of Pediatrics), as well as the What to Expect books by Heidi Murkoff.
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