Recently, we had a patient referred to us at the beginning of her third trimester because of suspected abnormalities on an office scan. The patient had a "keepsake" ultrasound performed at 15 weeks, with her extended family in attendance, and came to us with the pictures. She had not been told that there were any abnormalities, and although the images she showed us clearly did not look normal, it was evident that she had been reassured by the scan.
Entrepreneurial sonographers have been opening offices, usually in shopping malls, with cute names like Womb with a View, Baby's 1st Impressions, and Stork's View for some time. They offer "keepsake" sonogram photos and videos, often using 3-D imaging. Prospective parents can discern facial features and often fetal gender from these striking images. Most purveyors of keepsake imaging warn prospective parents that the images are not intended for diagnostic purposes. For example, the Stork's View Web site defines its service as "an elective prenatal ultrasound that gives the parents-to-be, family members, and friends an opportunity to view the unborn baby using ultrasound imaging technology, strictly for photographic purposes. . . .There are limitations on what is evaluated, and measurements are not taken. We require that you have had a routine diagnostic ultrasound examination ordered by your physician to evaluate for fetal anomalies no earlier than 18 weeks, before we will image your baby."1 Unfortunately, as in the case presented earlier, such scans can falsely reassure prospective parents. Also, as seen in this case, they may create an awkward situation for parents if anomalies are later diagnosed, and the pregnancy is either terminated or lost. For example, Baby's 1st Impressions encourages expectant couples to "bring your family and friends to join you in this amazing experience."2 Charges vary from less than $100 to $200, depending on the purveyor, time spent, and number of images obtained.
So why shouldn't expectant couples take advantage of this service, as long as they practice caveat emptor? There are a number of reasons why such nonmedical use of ultrasound should be discouraged.