Peek a boo, I see you

Not so long ago, the first time a mother saw her child's face was moments after he or she entered this world.

Now, because of advanced ultrasound technology, she can see her baby's heart beat and its expressions, from the womb.

Such technology "has revolutionized the practice of obstetrics/gynecology," said Dr. F.C. Gapultos, an obstetrician/gynecologist in

Sheffield.

Ultrasound is the use of sound waves to create vibrations that reflect off tissue to create picture.

During the past 30 years, it has increasingly integrated into obstetrics. Ultrasound is a noninvasive way for physicians to check for birth defects, to determine a fetus' sex and to gauge blood flow. Gapultos compared ultrasound to doing a physical exam on a fetus.

Before ultrasounds were in doctors' offices, a woman had to wait about 16-20 weeks to find out the age of her baby, Gapultos said. Now, six to 12 weeks is the norm.

Ultrasound also has changed the environment in which a woman discovers whether or not she's carrying a boy or girl.

"The excitement has changed from the labor room to the doctor's office as far as determining the baby's sex," Gapultos said.

Ultrasounds in 2D allow doctors to see a fetus' internal organs. Through "slices" of images, not unlike a slice of wood from a tree trunk, they can see blood flow, the heart beat, the kidneys and the brain.

In 3D, the transducer used on a woman's abdomen takes a series of pictures. Newer 4D technology shows surface images of a baby's muscle definition and hair. Volume is updated quickly enough so motion appears on screen in realtime.

Gapultos sees little advantage in 4D over black-and-white calling 4D "more of a patient pleaser than

anything."

In print, it's hard to distinguish 3D from 4D.

"The black-and-white image of the ultrasound is superior to 3D/4D," he said.

He said 4D ultrasound advertisement is misleading.

"Even I was kind of deceived because on the commercials you see the baby smile," Gapultos said.

Capturing a fetus' expression depends on its position in the womb, and "70 percent of the time, you don'tget the image you want to portray," he said.

Ultrasound centers that offer no medical expertise, referred to as "entertainment ultrasound," promise customers high-quality 4D portraits of their unborn children.

Dana Chandler isn't crazy about the phrase "entertainment ultrasound."

"I don't really care for that term at all," said Chandler, manager of the nonmedical ultrasound center, Images of Life, in Montgomery.

"The reason being, in today's time where insurance cutbacks (are so severe), when a mother goes in to get an ultrasound, the mother isn't really allowed to bond with her child."

The FDA discourages such use of ultrasound.

"Even without a state law, ultrasound machines are only supposed to be used for medical purposes according to the FDA," said Dr. Deborah Levine, chairwoman of the American College of Radiology Ultrasound

Commission.

The American Institute of Ultrasound in Medicine (AIUM) opposes nonmedical ultrasound. In a statement, it cites that there is no proof that ultrasound technology has a harmful effect on patients or their babies, but proof could be found in the future. In other words, it's better to be safe than sorry.

Dr. Joshua Copel, president of the AIUM, agrees.

"I believe ultrasound is probably safe, but there's no way in medicine to prove a negative," he said.

"Everything in medicine is done for a benefit," said Dr. Steve Ferzoco, a radiologist at Eliza Coffee Memorial Hospital in Florence. "Why do something that really is of no benefit to the baby or the mother?"

Chandler said centers like hers allows parents to look at their babies "without the pressure to look for abnormalities." After a woman has been examined by her physician, a registered sonographer scans a woman's womb with a transducer for about 25 minutes. An ultrasound at a physician's office takes about 10-15 minutes, Gapultos said.

Patients should check to see if their physicians offer 4D ultrasound to be in compliance with the FDA.

Jennifer Crossley can be reached at 740-5743 or

jennifer.crossley@timesdaily.com.