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Astrid Cohen
Professor Wolcott
ENC 1102
23 July 2014
The Detection of Birth Defects Through Ultrasound
Introduction
Ultrasound was first used in WWII to detect submarines. Then slowly they started
to be used in the medical field. Now an ultrasound is an imaging method that uses
soundwaves to produce images of a baby in a mother’s body. In the last 15 years they
have become more and more advanced, now there are 3D and 4D images of the baby.
Ultrasounds are vital to monitor the baby’s health and to see due date and gender. It has
been proven that there are no risks to getting ultrasounds done. I decided that this is the
field that I wanted to go into, and wanted to become an ultrasound technician. In
conversation of his field it is usually gynecologists, obstetricians, and cardiologists
talking.
Doctors and researchers from all over the world talk about how ultrasound is used
to detect birth defects. Several tests are performed to test the best time to screen and for
which defects. A term that is used in several articles is CHD. This means Congenital
Heart Defects, which is a heart abnormality starting in the womb. The articles cover
defects from HIV to cleft lip and clubfoot. Most of the articles came to the same
conclusion of when the best time to screen was. Some of the tests were run in different
parts of the world, because in less developed countries ultrasound is not as easily
assessable as it is here. It is important for childbearing woman to be educated on when
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the best time to test is because if found early, the defect could possibly be treated. This
paper will show the conversation going on between researchers and doctors on detecting
defects through ultrasound all over the world.
Ultrasounds in Different Countries
Every country has different levels of how advanced their medical technologies
are. The studies that were done in the United States seemed to have better results when
they tested in the first trimester (Cragan, Gilboa, 2009; Kresser 2011; Fergal, 2005). The
technology is a little more advanced, and the technicians and doctors had more training
than in less developed countries. In the U.S. the doctors use serum markers and nuchal
translucency (fluid under baby’s skin) to test for defects, and in all the studies it seemed
to be affective.
The other countries where the research was done were Europe (Barisic et al, 2001;
Pilalis, 2012), The Netherlands (Baardman et al, 2014; Wiesel et al, 2005), and South
America (Campana, 2010). Some of these countries, such as South America, had similar
detection rates to the United States. But in places like Greece, the doctors found that it
would be beneficial for more training and better technology. Termination of pregnancies
was a lot more common in Europe, so it seems that abortion is a more acceptable concept
there. All in all, it depends on where the research is done on whether the patient is getting
the best results.
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Levels of Difficulty For Detection
All defects have different affects on people. Some can be detected from structural
differences, chromosomal changes, or heart abnormalities. Defects with structural
abnormalities are the easiest to detect (Cragan, Gilboa, 2009). Chromosomal defects are
usually hardest to detect because there is nothing visibly wrong with the baby so it takes
more than just an ultrasound. It is important to test to see the severity of the defect
because, if it is caught soon enough, there can be ways to prevent it from getting worse.
In some cases, when the mother’s found out about their baby’s defect, the pregnancy was
terminated (Barisic et al, 2001). The serum markers and nuchal translucency tests help
with finding defects that are not as visible.
Research Gap
There is a lot of research done on finding defects through ultrasound and the
expertise it takes to do so. But as I was reading these articles I found that there was no
much on the training of the ultrasound technicians. In fact, two of the articles stated that
there needed to be better training for detecting defects (Khalil, Asma, Nicolaides, 2013;
Pilalis, 2012). Ultrasound techs are only required to finish ultrasound school but are not
required to have a college degree. It is in the medical field so most would think that it
would require some kind college education. It is important for technicians to know what
they are doing because they are dealing with people’s babies. Ultrasound technicians
need to be educated on not only the machine but also about defects and any other
problems with the pregnancy. Having the most knowledge as possible on the topic is
better because patients want to know that their technician are educated and know what
they are doing.
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Project Proposal
Since this topic has no research done on it, there is no way to tell if ultrasound
technicians are better off having a college education along with going to ultrasound
school. If I wanted to test whether a college education would benefit technicians or not I
would conduct several different surveys and tests, which examine not only the techs
themselves but also the people they work with. It is important that techs tell their patients
and the doctor the right information in order for nothing to go wrong. College might offer
more insight into that field, therefore helping the techs with knowing as much as they can
about their job.
The first survey I would conduct would be to see what the patients want. I would
venture to say that most patients would want their ultrasound technicians to have as much
training and education as possible, considering the fact that they are dealing with their
health. The next survey I would do is to see what the doctors that are employing the techs
would want. Doctors want what is best for their office and patients but some might feel
that the techs having a college education might not make a big difference. I would want
to ask what their expectations are for their employees. Next, I would try comparing the
salaries of technicians with a college degree and technicians with just the ultrasound
degree. If the college graduates had bigger incomes then I think more people would go to
college before attending ultrasound school so they can have a better salary. Lastly I
would want to test ultrasound technicians on their actual knowledge of ultrasounds. For
example, I would ask what signs do they have to look for with what defect and actual
knowledge on the defects. I would test a group of techs with a college degree and a group
with only the ultrasound degree. This way there would be actual research on whether
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college is beneficial or not. With these kinds of tests patients, employers, and future
ultrasounds techs can be sure on what is the best education for this professor.
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Works Cited
Baardman, M. E., et al. "Impact Of Introduction Of 20-Week Ultrasound Scan On
Prevalence And Fetal And Neonatal Outcomes In Cases Of Selected Severe
Congenital Heart Defects In The Netherlands." Ultrasound In Obstetrics &
Gynecology 44.1 (2014): 58-63. Academic Search Premier. Web. 9 July 2014.
Barisic, I., Clementi, M., Häusler, M., Gjergja, R., Kern, J. and Stoll, C. (2001),
Evaluation of prenatal ultrasound diagnosis of fetal abdominal wall defects by 19
European registries. Ultrasound Obstet Gynecol.
Campana, H, et al. "Prenatal Sonographic Detection Of Birth Defects In 18 Hospitals
From South America." Journal Of Ultrasound In Medicine 29.2 (n.d.): 203-212.
Science Citation Index. Web. 9 July 2014.
Cragan, JD, and SM Gilboa. "Including Prenatal Diagnoses In Birth Defects Monitoring:
Experience Of The Metropolitan Atlanta Congenital Defects Program." Birth
Defects Research Part A-Clinical And Molecular Teratology 85.1 (n.d.): 20-29.
Science Citation Index. Web. 9 July 2014.
Khalil, Asma, and Kypros H. Nicolaides. "Fetal Heart Defects: Potential And Pitfalls Of
First-Trimester Detection." Seminars In Fetal And Neonatal Medicine 5 (2013):
251. Academic OneFile. Web. 9 July 2014.
Kresser, Chris. "Natural Childbirth IIa: Is Ultrasound Necessary & Effective in
Pregnancy?" Chris Kresser. N.p., n.d. Web. 10 July 2014
Fergal, Malone. "First-Trimester or Second-Trimester Screening, or Both, for
Down's Syndrome — NEJM." New England Journal of Medicine. N.p., 5 Nov.
2005. Web. 9 July 20
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Wiesel, A., et al. “Prenatal Detection of Congenital Renal Malformations by Fetal
Ultrasonographic Examination: An Analysis of 709,030 Births in 12 European
Countries” European Journal of Medical Genetics Volume 48 Issue 2. April–June
2005. 14 July 2014.