Elective ultrasounds are non-medical imaging procedures, commonly using three-dimensional (3D) and four-dimensional (4D) technology, performed solely for obtaining keepsake images, videos, or determining the baby’s gender. Unlike scans ordered by a healthcare provider, these sessions are not intended to assess the health or development of the fetus. This practice raises questions about the potential effects of exposing the developing baby to ultrasound energy without a medical reason. Understanding how this technology interacts with tissue addresses the safety concerns surrounding this non-diagnostic use.
The Mechanism of Ultrasound: How it Works and Potential Effects
Ultrasound technology relies on high-frequency sound waves that travel through tissue, reflect off structures, and return to a transducer to create an image. The energy carried by these sound waves can produce two primary biological effects, monitored by the machine’s safety indicators. The Thermal Index (TI) is a calculated estimate of the potential for tissue heating, which occurs as the body absorbs acoustic energy. A TI value of 1.0 suggests a one-degree Celsius temperature rise above the normal physiological temperature.
The Mechanical Index (MI) is the second safety indicator, estimating the likelihood of mechanical effects, primarily cavitation. Cavitation refers to the formation and oscillation of microscopic gas bubbles within the tissue under the influence of pressure changes. While diagnostic ultrasound operates at levels where these effects are considered negligible, prolonged exposure or high intensity increases the potential for both tissue heating and bubble formation. Because the TI and MI values are relative indicators, the user is responsible for ensuring the acoustic output remains within safe parameters.
Key Differences Between Diagnostic and Elective Scans
The differences in how diagnostic and elective ultrasounds are performed introduce variables that influence the risk profile. Diagnostic scans are targeted and brief, focusing on obtaining specific medical information such as measurements or organ assessments. Conversely, elective sessions are often prolonged, sometimes lasting 30 to 60 minutes, as the operator attempts to capture the perfect image or video.
This extended exposure time increases the total acoustic energy delivered to the fetus, directly relating to the potential for thermal effects. Elective facilities frequently utilize 3D and 4D imaging modes, which require higher acoustic output and intensity settings to generate the detailed pictures sought by parents. Higher intensity settings result in increased Thermal Index and Mechanical Index values compared to the lower-power, two-dimensional (2D) modes used for routine diagnostic checks.
Operator training also presents a significant difference between the two types of scans. Diagnostic ultrasounds are performed by certified sonographers who are trained to adhere to the ALARA principle (“As Low As Reasonably Achievable”). Many elective imaging centers, however, employ non-credentialed personnel who may not possess the medical training necessary to understand fetal risk or the bioeffects of prolonged exposure. This lack of medical oversight and adherence to safety protocols means the fetus may be exposed to unnecessary or prolonged energy levels.
Official Safety Stances and Professional Warnings
Major health and regulatory organizations have issued warnings against the use of ultrasound for non-medical purposes. The U.S. Food and Drug Administration (FDA) views ultrasound machines as prescription medical devices intended for use by trained healthcare professionals. The FDA explicitly discourages the use of these devices for creating fetal keepsake images and videos, considering it an unapproved use of a medical device.
The FDA’s warning stems from the understanding that while there is no confirmed evidence of harm from diagnostic ultrasound, the long-term effects of tissue heating and cavitation from unnecessary exposure are not fully known. They assert that scans should only be performed when there is a medical need, ensuring the medical benefit outweighs any potential risk.
The American College of Obstetricians and Gynecologists (ACOG) and the American Institute of Ultrasound in Medicine (AIUM) share this position, advising against keepsake ultrasounds. ACOG has endorsed the AIUM statement that discourages the non-medical use of ultrasound for psychosocial or entertainment purposes, calling it inappropriate and contrary to responsible medical practice.
Professional bodies emphasize that exposing a developing fetus to ultrasound energy for no medical reason is unnecessary. The absence of a medical indication means there is no health benefit to offset the potential risk of prolonged or high-intensity exposure. ACOG also notes that non-medical ultrasounds may falsely reassure women about the health of their baby, potentially leading to a delay in seeking medical attention for problems missed by an untrained operator.