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Ultrasound in Pregnancy

Ultrasound: high-frequency sound waves that travel at 10 to 20 million cycles per second. The pattern of echo waves creates a picture of tissue and bone.

In 1987, UK radiologist H.D. Meire, who had been performing pregnancy scans for 20 years, commented, “The casual observer might be forgiven for wondering why the medical profession is now involved in the wholesale examination of pregnant patients with machines emanating vastly different powers of energy which is not proven to be harmless to obtain information which is not proven to be of any clinical value by operators who are not certified as competent to perform the operations”.

Routine prenatal ultrasound (RPU) actually detects only between 17 and 85 percent of the 1 in 50 babies who have major abnormalities at birth. RPU can identify a low-lying placenta (placenta previa). However, 19 of 20 women who have placenta previa detected on an early scan will be needlessly worried: the placenta will effectively move up without causing problems at the birth. Furthermore, detection of placenta previa by RPU has not been found to be safer than detection in labor.

The American College of Obstetricians has concluded that “in a population of women with low-risk pregnancies, neither a reduction in perinatal morbidity and mortality nor a lower rate of unnecessary interventions can be expected from routine diagnostic ultrasound. Thus ultrasound should be performed for specific indications in low-risk pregnancy.

Effects of ultrasound include cavitation, a process wherein the small pockets of gas that exist within mammalian tissue vibrate and then collapse. In this situation “…temperatures of many thousands of degrees Celsius in the gas create a wide range of chemical products, some of which are potentially toxic. These violent processes may be produced by microsecond pulses of the kind which are used in medical diagnosis.” (American Institute of Ultrasound Medicine Bioeffects Report 1988). The significance of cavitation in human tissue is unknown.

Studies have suggested that these effects are of real concern in living tissues:

Cell abnormalities caused by exposure to ultrasound were seen to persist for several generations.

In newborn rats (similar stage of development as human fetuses at four to five months in utero), ultrasound can damage the myelin that covers nerves.

Exposing mice to dosages typical of obstetric ultrasound cased a 22% reduction in the rate of cell division and doubling of the rate of aptosis (programmed cell death), in the cells of the small intestine.

Two long-term randomized controlled trials comparing exposed and unexposed childrens’ development at eight to nine years old found no measurable effect from ultrasound. However, the authors comment that intensities used today are many times higher than there were in 1979 and 1981.

– Excerpted from “Ultrasound Scans: Cause for Concern”

References:

American College of Obstetricians and Gynecologists (ACOG) Routine Ultrasound in Low-Risk Pregnancy. In:ACOG Practice Patterns- Evidence-Based Guidelines for Clinical Issues in Obstetrics and Gynecology. Number 5 August 1997

Association for Improvements in the Maternity services (AIMS)- AIMS UK. Ultrasound Unsound? AIMS Journal vol 5 no 1, spring 1993.

American Institute of Ultrasound Medicine Bioeffects Report 1988. J Ultrasound Medicine 7S1-S38. Sept 1988

Beech BL. Ultrasound- unsound? Talk at Mercy Hospital, Melbourne, April 1993

Brand IR, Kaminopetros P, Cave M et al. Specificity of antenatal ultrasound in the Yorkshire region: a prospective study of 2261 ultrasound detected anomalies. Br J Obstet Gynaecol 1994. Vol 101, no5. pp 392-397

Brookes, A. Women’s experience of routine prenatal ultrasound. Healthsharing Women: The newsletter of Healthsharing Women’s Health Resource Service. Vol 5, no’s 3 & 4. Dec 1994- March 1995.
Campbell JD et al Case-control study of prenatal ultrasonography in children with delayed speech. Can Med Ass J 1993 vol 149 no 10 pp1435-1440

Chan FY. Limitations of Ultrasound. Paper presented at Perinatal Society of Australia and New Zealand 1st Annual Congress, Freemantle 1997

Davies J et al. Randomised controlled trial of doppler ultrasound screening of placental perfusion in pregnancy. Lancet 1992;340:1299-1303

De Crespigny L, Dredge R. Which Tests for my Unborn Baby, Revised Edition. Oxford University Press, Melbourne 1996.

Ellisman MH, Palmer DE, Andre MP. Diagnostic levels of ultrasound may disrupt myelination. Experimental Neurology 1987 vol 98 no 1 pp78-92

Ewigman BG, Crane JP, Frigoletto FD et al. Effect of prenatal ultrasound screening on perinatal outcome.RADIUS study group. N Engl J Med . 1993 vol 329, no 12, pp821-7

Geerts JGM, Brand E, Theron B. Routine obstetric ultrasound in South Africa: cost and effect on perinatal outcome- a prospective randomised controlled trial. Br J Obstet Gynaecol 1996. Vol 103. pp501-507

Kieler H, Axelsson O, Nilsson S, Waldenstrom U. Comparison of ultrasonic measurement of biparietal diameter and last menstrual period as a predictor of day of delivery in women with regular 28 day cycles. Acta-Obstet-Gynecol-Scand, 1993 vol 75 no 5 pp 347-9
Kieler H, Axelsson O, Haguland B, et al. Routine ultrasound screening in pregnancy and the children’s subsequent handedness. Early Hum Dev 1998 , vol 50 no 2, pp233-245

Kieler H, Ahlsten G, Haguland B et al. Routine ultrasound screening in pregnancy and the children’s subsequent neorological development. Obstet Gynecol 1998 vol 91 5 (pt 1) pp750-6
Kieler H, Cnattingius S, Haglund B et al. Sinistrality- a side-effect of prenatal sonography: A comparative study of young men.Epidemiology 2001:12 (6):618-23

Luck CA. Value of routine ultrasound scanning at 19 weeks: a four year study of 8849 deliveries. BMJ 1992, vol 34, no 6840, pp1474-8

Liebeskind D, Bases R, Elequin F et al. Diagnostic ultrasound: effects on the DNA and growth patterns of animal cells. Radiology 1979 vol 131, no1, pp 177-184

Lorenz RP, Comstock CH, Bottoms SF, Marx SR. Randomised prospective trial comparing ultrasonography and pelvic examination for preterm labor surveillance. Am J Obstet Gynecol 1990 vol 162 no 6 pp 1603-1610

Marinac-Dabic D, Krulewitch CJ, Moore RM Jr. The safety of prenatal ultrasound exposure in human studies. Epidemiology 2002 May; 13(3 Suppl):S19-22

Meire HB. The safety of diagnostic ultrasound (commentary). Br J Obstet Gynaecol 1987 vol 94, pp1121-1122

MIDIRS. Informed Choice for professionals leaflet no 3. Ultrasound screening in the first half of pregnancy: is it useful for everyone? MIDIRS and the NHS centre for Reviews and Dissemination. 1996

Mole R. Possible hazards of imaging and Doppler ultrasound in obstetrics. Birth 1986 vol 13, pp329-37

Neilson JP.Ultrasound for fetal assessment in early pregnancy (Cochrane Review). In:The Cochrane Library, Issue 2, 2002. Oxford” Update Software

New Scientist Shadow of doubt 12 June 1999, p23
Newnham J, Evans SF, Michael CA et al. Effects of frequent ultrasound during pregnancy: a randomised controlled trial. Lancet 1993, vol 342, no 8876, pp887-91

Newnham JP et al. Doppler flow velocity wave form analysis in high risk pregnancies: a randomised controlled trial. Br J Obstet Gynaecol, 1991,vol 98 no 10, pp956-963

Oakley Ann The history of ultrasonography in obstetrics. Birth, 1986 vol 13, no 1, pp 8-13

Odent M. Where does handedness come from? Primal Health Research Quarterly 1998, vol 6 no 1.

Olsen O et al. Routine ultrasound dating has not been shown to be more accurate than the calendar method. Br J Obstet Gynaecol 1997, Vol 104 No 11 pp1221-2

Rothman, Barbara Katz. The Tentative Pregnancy: Amniocentesis and the Sexual Politics of Motherhood. (2nd ed) Pandora 1994
Saari-Kemppainen A, Karjalainen O, Ylostalo P et al. Ultrasound screening and perinatal mortality: controlled trial of systematic one-stage screening in pregnancy. The Helsinki ultrasound trial. Lancet 1990 vol 336, no 8712. pp 387-391

Salvesen KA, Bakketeig LS, Eik-nes SH et al. Routine ultrasonography in utero and school performance at age 8-9 years. Lancet 1992, vol 339 no 8785 pp 85-89

Salvesen KA, Vatten LJ, Eik-nes SH et al. Routine ultrasonography in utero and subsequent handedness and neurological development. BMJ 1993: vol 307 no 6897 pp159-64

Salvesen KA, Ein-nes SH et al. Ultrasound during pregnancy and subsequent childhood non-right handedness- a meta-analysis. Ultrasound Obstet Gynecol 1999; 13(4) 241-6.

Sparling JW, Seeds JW, Farran DC. The relationship of obstetric ultrasound to parent and infant behavior. Obstet Gynecol 1988 vol 72 no 6. pp 902-7

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Taylor KJW A prudent approach to ultrasound imaging of the fetus and newborn. Birth 1990. Vol 17 no 4, pp218-223

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Thacker SB. Quality of controlled clinical trials. The case of imaging ultrasound in obstetrics: a review. Br J Obstet Gynaecol, 1985 vol 92, no 5, pp 437-444

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Watkins D. An alternative to termination of pregnancy. The Practitioner,1989, vol 233 no 1472,pp990, 992.

 

Back Pain During Pregnancy

As your pregnancy advances and your uterus enlarges, you’re likely to feel some discomfort. Back pain is a common complaint.

But you don’t have to grin and accept back pain as a normal part of your pregnancy. You can take steps to stop the soreness. It’s a good idea to learn these techniques now, because you’ll probably need them again later when your back is bearing the strain of constantly lifting your 7- to 10-pound baby or your 20-pound toddler.

What causes back pain in pregnancy?

At least 50 percent of women experience back pain during pregnancy. Pregnant women are prone to backaches and back pain for a number of reasons:

Extra weight. The weight you gain during pregnancy is good for your baby, but it can be bad for your back.

Change in center of gravity. As your uterus grows, your center of gravity shifts forward. Gradually— and perhaps without notice—you begin to adjust your posture and the way you move. These compensations can lead to backaches and back pain.

Your hormones. During pregnancy, the hormone relaxin causes the ligaments between your pelvic bones to soften and your joints to loosen in preparation for your baby’s passage through your pelvis during birth. As the structures that support your pelvic organs become more pliant, you may feel considerable discomfort on either side of your lower back, often with walking, especially up and down stairs.

Back pain can occur at any time during pregnancy. For many women, it interferes with daily activities and the ability to get a good night’s sleep.

What can you do?

These self-care strategies can put your back on track:

Pay attention to your posture. The healthy posture that you learned before you were pregnant still applies in early pregnancy, before your uterus is above your bellybutton. Tuck your buttocks under, pull your shoulders back and downward, and stand straight and tall.

Later in pregnancy, as your uterus enlarges, you naturally pull your shoulders back farther to offset the weight of your uterus pulling you forward. This can actually cause back strain. Talk to your doctor about adjusting your posture to accommodate your growing belly.

Make adjustments when sitting or standing. Sit with your feet slightly elevated, and don’t cross your legs. Change position often, and avoid standing for long periods of time. If you must stand for a while, rest one foot on a low step stool.

Strategically place your pillows. Sleep on your side, with one or both knees bent. Place a pillow between your knees and another one under your abdomen. You may also find relief by placing a specially shaped total body pillow under your abdomen.

Avoid lifting heavy objects or children. When lifting a smaller object, don’t bend over at the waist. Instead, squat down, bend your knees and lift with your legs rather than your back. Try to avoid sudden reaching movements or stretching your arms high over your head.

Get the right gear.Wear supportive, low-heeled shoes and maternity pants with a low, supportive waistband. Or consider using a maternity support belt.

Try heat, cold or massage. Apply heat to your back. Try warm bath soaks, warm wet towels, a hot water bottle or a heating pad. Some women find relief by alternating ice packs with heat. A back massage also may help.

Stay fit. As long as your health care provider approves, an exercise program can keep your back strong and may actually relieve back pain. Some women enjoy swimming, and doctors highly recommend it—the body’s buoyancy in the water offers relief from the extra weight of pregnancy. You also might like walking or taking a prenatal exercise or yoga class. On your own, you can try an exercise called a pelvic tilt or cat stretch: Kneel on your hands and knees with your head in line with your back. Pull in your abdomen, arching your spine upward. Hold the position for several seconds, then relax your abdomen and back. Repeat three to five times, working gradually up to 10.

If these self-care steps aren’t working or your back pain is severe, talk to your health care provider. He or she may suggest a variety of approaches, such as special stretching exercises, that can alleviate pain without causing concern for your unborn baby.

Pain in your back may be a sign of a more serious problem if it’s severe and unrelenting or if it’s accompanied by other signs and symptoms. A low, dull backache may be a sign of labor or preterm labor. So, it’s best not to ignore your aching back.

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Neck Pain Treatment With Chiropractic

Most neck pain related injuries are due to work environment. Often happens to people who spend over 8 – 10 hours behind computers at work. After a constant forward head posture looking into a computer monitor with each day closer and closer because their eyes are getting tired and cannot see as well, acute neck pain begins with achiness and dullness. People are so busy with their daily life, not realizing that they need to stop for few seconds and take a break to improve their posture. They would just pop a pill to alleviate their pain so that they can continue with their work. Before they know it, their acute achy pain quickly turns into chronic neck pain that even painkillers cannot help, because degenerative process has began in their neck.

Chiropractic care has been around for over 100 years helping people not only reduce and eliminate pain and suffering drug free, but also correct the root cause of their neck pain. Here at Nektalov Chiropractic Center we concentrate educating our patients in ergonomics for their workplace. Chiropractic care is absolutely pain free treatment and extremely effective in correcting the root cause of the Neck Pain.

ELIMINATING NECK AND BACK PAIN

Falling at the construction sites are the most frequently occurring and costly accidents across the US. This mechanism of injury accounts for about 70 percent of all claimed injuries. Many of those injuries are simply due to accidents. Having that back or neck pain is not a joke and missing those work days can be costly. Most importantly not treating that acute pain as soon as possible can turn into chronic pain that will hunt you forever.

Chiropractic care for these types of injuries is a gold standard treatment, that is not invasive or use of pain killers. We travel all over the world to obtain latest cutting edge information and technology on treating neck and back pain safely and effectively. One of the greatest tools that we have been utilizing at our healing center is Active Therapeutic Movement technique that is very powerful in eliminating your pain from 50% to 100% on the first visit, following with chiropractic treatment to correct the cause of your pain.

Migraine Headaches

Over 37 million people are suffering from constant migraine headaches in America. A study has showed since 1980s the number of people with migraine headaches rose by 60%. Almost 5 million of people in America experience at least one migraine headache per week.

• 91% miss work or cannot function normally during migraine headache
• 70% of all migraine headache sufferers are women
• 69% have consulted a medical physician at some time seeking treatment
• Over 50% have one or more migraine headaches weekly
• Over 50% missed family or social events

Migraine headaches cause losses into the millions when people start missing work. Over 90% are using over the counter pain killers to treat their migraine headaches, not realizing that the cause of the migraine headache is not lack of pain killers in their blood stream.

If you are suffering from migraine headache, please get your cervical spine check as soon as possible. Studies show that loss of cervical curve is direct correlation with migraine headaches. Getting x-rays of the neck will show exactly where the problem is coming and how long it’s been there.