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What Do Clinical Users Know Regarding Safety of Ultrasound During Pregnancy?

Department of Obstetrics and Gynecology, Rush University Medical Center, Chicago, Illinois USA (E.S., J.S.A.); Department of Obstetrics and Gynecology, Soroka University Medical Center, Beer-Sheva, Israel (E.S.); and Faculty of Health Sciences (E.S.) and Epidemiology and Health Services Evaluation Department, Faculty of Health Sciences (I.S.-V.), Ben-Gurion University of the Negev, Beer-Sheva, Israel.

Address correspondence to Eyal Sheiner, MD, Department of Obstetrics and Gynecology, Rush University Medical Center, 1653 W Congress Pkwy, Chicago, IL 60612 USA. E-mail: sheiner{at}bgu.ac.il

Objective. The main goal of this study was to determine end users’ knowledge regarding safety aspects of diagnostic ultrasound during pregnancy. End users’ attitudes toward the use of ultrasound in low-risk pregnancies were also assessed. Methods. A questionnaire was distributed to ultrasound end users attending review courses and hospital grand rounds between April and June 2006. Results. One hundred thirty end users completed the questionnaires (63% response rate). Sixty-three percent were physicians (n = 84), most of them obstetricians (81.7%). About 18% of participants routinely performed Doppler ultrasound examinations during the first trimester. Fifty percent of end users thought that the number of ultrasound examinations in low-risk pregnancy should be limited to 1 to 3 (mean ± SD, 2.6 ± 0.9). Almost 70% disapproved of "keepsake/entertainment" ultrasound. Although 32.2% of the participants were familiar with the term thermal index, only 17.7% actually gave the correct answer to the question on the nature of the thermal index. About 22% were familiar with the term mechanical index, but only 3.8% described it properly. Almost 80% of end users did not know where to find the acoustic indices. Only 20.8% were aware that they are displayed on the sonographic monitor during the examinations. End users with higher knowledge of safety issues thought that there should be limitations on the number of ultrasound examinations in low-risk pregnancies (odds ratio, 3.3; 95% confidence interval, 1.1–10.0; P = .028). Likewise, these end users were more likely to respond that ultrasound might have adverse effects during pregnancy (odds ratio, 3.2; 95% confidence interval, 1.1–12.5; P = .045). Conclusions. Ultrasound end users are poorly informed regarding safety issues during pregnancy. Further efforts in the realm of education and training are needed to improve end user knowledge about the acoustic output of the machines and safety issues.

Key Words: acoustic output • mechanical index • questionnaire survey • safety • thermal index • ultrasound

Abbreviations: CI, confidence interval • MI, mechanical index • Ob/Gyn, obstetrics and gynecology • ODS, output display standard • OR, odds ratio • TI, thermal index

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