Ultrasound Biosafety During Pregnancy: What Do Operators Know in the Developing World?

Abstract

Objectives The purpose of this study was to evaluate the knowledge and attitudes of ultrasound users toward safety aspects during routine obstetric examinations. Methods A self‐administered questionnaire was given to all registered participants of the 10th Annual International Radiological Conference in Karachi, Pakistan. Results A total of 306 participants completed the questionnaire (response rate, 70%), including 170 consultant radiologists (55%), 90 radiology residents (30%), 31 sonographers (10%), and 15 others (5%). The mean sonography experience of the end users ± SD was 5.1 ± 5 years. Around half of the participants (45.5%) reported that there should be limitations on the use of ultrasound during low‐risk pregnancy. Overall, safety knowledge was inadequate among the participants. However, those who were concerned about limitations on the use of ultrasound during pregnancy were 2.5 times more likely to be familiar with the mechanical index (P < .001) and 1.8 times more likely to be familiar with the thermal index (P < .001). Conclusions Increased training for professionals on safety issues of ultrasound procedures during pregnancy is needed. Furthermore, the concept of the absolute safety of ultrasound procedures without knowledge of safety parameters such as the mechanical and thermal indices needs to be changed, and more clarity is required when defining parameters under which the procedures can be safely performed.

National survey of Australian sonographer knowledge and behaviour surrounding the ALARA principles when conducting the 11-14-week obstetric screening ultrasound

“…2,[25][26][27][28][29][30] It is interesting to note that despite this, in the two studies where the respondents were asked their opinion on 'keepsake' imaging (non-medically indicated or social), the disapproval rates were 71.1% 25 and 69.2%.…”

“…25,27 Necas 29 reports no sonographers with >10 years' experience could define or describe TI but 100% of respondents selfreported familiarity with TI, indicating a lack of information retention. We found Australian sonographers have good information retention of TI knowledge regardless of time since qualification (P = 0.366).…”

First look: a cluster-randomized trial of ultrasound to improve pregnancy outcomes in low income country settings

“…In HIC, prenatal care is nearly universal, and, as part of that care, obstetric ultrasound is used routinely to determine gestational age and screen for complications including multiple gestations, fetal anomalies, mal-presentation, and placenta previa [19]. In LIC, factors including high cost of the ultrasound equipment, lack of trained sonographers or physicians, as well as the skill required for performing the examinations have been among the barriers to use [20,21]. …”

Ultrasound in the First Trimester and Earlier: How to Keep It Safe

“…Both in Europe [61] and the USA [62], approximately 70 % of clinicians (physicians and sonographers, including nurses who perform ultrasound) show very poor, or no knowledge of bioeffects and safety issues, do not know what TI and MI represent and do not even know that these appear on-screen during clinical ultrasound examinations. This is true in several other countries [63][64][65] as well as among residents/fellows [66] and sonographers, regardless of their seniority [67]. Furthermore, several assumptions were made when formulating the indices, which bring questions on their clinical value [68].…”

“…comm.). Indeed, as mentioned earlier, a major issue is the lack of knowledge of ultrasound clinical users on output, bioeffects and safety, both in the USA [62] and abroad [61,63,64]. …”