Fetal Ultrasound for Non-Medical Reasons


Policy Number:#4-10
Policy Category: Practice
Under Review: No
Approved by Council: May 2004
Reviewed and Updated: May 2010
Publication Date: Dialogue, Issue 2, 2010
To be Reviewed by: May 2004
College Contact: Quality Management Division

Downloadable Version(s): Fetal Ultrasound for Non-Medical Reasons


Purpose

Physicians routinely order or perform diagnostic fetal ultrasounds during the course of their patient’s pregnancy. At times, physicians may be asked by expectant mothers and their families to order or perform a fetal ultrasound for non-medical reasons.

The purpose of this policy is to outline the College’s expectations of physicians with respect to ordering and performing fetal ultrasounds.

Principles

  1. The physician’s responsibility is to act in the best interests of the patient.
  2. Acting in the patient’s best interest includes maintaining the medical knowledge and clinical skills necessary to provide quality care to patients.

Background

Diagnostic fetal ultrasound is an essential component of prenatal care. 1 Fetal ultrasound, in conjunction with other appropriate diagnostic tests, provides important medical information, such as the size, age and state of health of the fetus. 2

Fetal ultrasound technology is used by others for non-medical reasons, such as for entertainment or gender identification: 

  1. Entertainment
    As more advanced ultrasound technologies are becoming available, such as 3D/4D ultrasound, expectant mothers and their families are requesting fetal keepsake videos and portraits.
  2. Gender Identification
    Requests are sometimes made for the performance of an ultrasound to determine the sex of the baby for gender selection purposes.

There are a number of organizations that have formal statements that provide that the use of ultrasound for entertainment or fetal gender determination purposes is inappropriate. 3 The College of Physicians and Surgeons of Ontario’s Independent Health Facilities Program refers to these statements, along with this policy, when inspections are carried out in facilities where fetal ultrasounds are performed.

College Policy

Physicians must ensure that all diagnostic fetal ultrasounds are ordered and conducted for appropriate clinical indications, in accordance with relevant statements and guidelines.

The purpose of an imaging examination should always be to obtain information relevant to the diagnosis or treatment of a patient. Therefore, when ordering the diagnostic fetal ultrasound, the physician should specify the clinical indications.

If a physician orders or performs a diagnostic fetal ultrasound for medical reasons, they may provide their patients with any picture or video of the fetus that is created as a result of that imaging examination.

However, it is inappropriate and contrary to good medical practice to use ultrasound only to view the fetus to obtain a picture or video of the fetus or to determine the gender of the fetus.


 

Endnotes

1 Experts in Canada recommend that all women have a diagnostic ultrasound when they are pregnant. The Society of Obstetricians and Gynaecologists of Canada has clinical guidelines with respect to diagnostic fetal ultrasound.

2 Health Canada, “Fetal Ultrasound for Keepsake Videos”, November 2003, available at: www.hc-sc.gc.ca/hl-vs/iyh-vsv/med/ultrasound-echographie-eng.php.

3 Health Canada, the Ontario Association of Radiologists, the Canadian Association of Radiologists, the Society of Obstetricians and Gynaecologists of Canada, the Canadian Society of Diagnostic Medical Sonographers, the Food and Drug Administration, the American College of Obstetricians and Gynecologists, and the American Institute of Ultrasound in Medicine are just some of the organizations that oppose the use of ultrasound for these purposes.
 

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