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Diagnostic Ultrasound

• Editor's Note
• List of Articles

Editor's Note

The applications of diagnostic ultrasound in obstetrics are numerous and provide reliable information whereby the health and well-being of the mother and unborn baby can be readily assessed. Included within these applications are the evaluation of early pregnancy; estimation and confirmation of gestational age; monitoring fetal growth, development and viability; in addition to its use as an adjunct to various interventional procedures such as amniocentesis, chorionic villus sampling, fetal blood sampling, and fetal surgeries. More recently, it has become possible to evaluate functional changes in blood flow in the uteroplacental and fetoplacental circulations in addition to the fetal heart and peripheral vasculature.

It has been almost five decades since the first ultrasonic devices for imaging the conceptus were developed. There continues to be a general belief in the medical community that ultrasound is "safe" and poses no risk to mother or fetus. The concept of two-tier ultrasound examination system was established on the principle one is more detailed than the other. Level I study is directed toward assessment of the following areas: pregnancy dates, fetal growth, number of fetuses, placental location, amniotic fluid, and major anomalies including anencephalus and obvious masses in fetal trunk, chest, and abdomen. Level II examination is directed toward detailed imaging of fetal anatomic structures; specifically it includes more detailed views of the heart and central nervous system.

Ethical dimensions of diagnostic ultrasound applied to obstetrics are a rigorous intellectual undertaking. Ethics is the disciplined study of morality, and morality concerns both right and wrong behavior, that is, what one ought and ought not to do, and good and bad character, that is, virtues and vices. Ethics in obstetric ultrasound deals with these same questions, focusing on what morality ought to be for physicians who employ this diagnostic technology in their practice. The bedrock for centuries for what morality ought to be in clinical practice has been the obligation to protect and promote the interests of the patient. This general ethical obligation must be made more specific if it is to be clinically useful. This can be accomplished by attending to different perspectives in terms of which the patient's interests can be understood. The interests of the patient can be understood from two perspectives: that of the physician and that of the patient.

Women's Health and Education Center (WHEC)