Can a pregnant patient undergo a live ultrasound?

Ultrasound Safety During Pregnancy

Yes, pregnant patients can safely undergo ultrasound examinations, as ultrasound is considered the imaging modality of choice during pregnancy with no documented adverse effects on the fetus. 1

Safety Profile of Ultrasound in Pregnancy

Ultrasound is widely regarded as the safest imaging option for pregnant women for several important reasons:

• No ionizing radiation exposure (unlike CT scans)
• No documented adverse effects on fetal development
• Provides real-time visualization of fetal anatomy and maternal structures
• Can be performed at any stage of pregnancy

Specific Ultrasound Applications During Pregnancy

Ultrasound serves multiple critical diagnostic purposes during pregnancy:

• Evaluation of suspected IBD flares: Guidelines recommend ultrasound as a first-line imaging modality for pregnant women with suspected inflammatory bowel disease 1
• Assessment of adnexal masses: Ultrasound is the primary imaging tool for characterizing ovarian and adnexal pathology during pregnancy 1
• Diagnosis of gallstones: Ultrasonography is specifically recommended as the imaging modality of choice for gallstone disease in pregnancy 1
• Evaluation of suspected pulmonary embolism: Lower-extremity duplex ultrasonography is recommended as an initial approach in pregnant patients with suspected PE and signs of DVT 1

Comparison with Other Imaging Modalities

When comparing imaging options during pregnancy:

• MRI: Safe alternative when ultrasound is insufficient, but should be used without gadolinium when possible 1
• CT scans: Should be limited due to radiation exposure, though can be performed when benefits outweigh risks 1
• Nuclear medicine studies: Should be avoided or modified with reduced radiopharmaceutical doses when absolutely necessary 1

Technical Considerations

The Society of Radiologists in Ultrasound provides specific terminology for first-trimester ultrasound findings 1:

• Intrauterine pregnancy (IUP) is defined as a pregnancy implanted in a normal location
• Eccentrically located gestational sacs completely surrounded by endometrium should be reported as IUP
• Cardiac activity should be reported in beats per minute, avoiding terms like "live" or "viable"

Important Caveats and Precautions

While ultrasound is considered safe, healthcare providers should be aware of:

• Ultrasound is a form of energy that demonstrates bioeffects in tissues (thermal and mechanical) 2
• The thermal index (TI) and mechanical index (MI) appear on ultrasound screens and should be monitored to ensure values remain within normal ranges 2
• Studies have found poor knowledge regarding ultrasound safety among some practitioners, highlighting the need for proper training 2

Special Applications

In certain situations, specialized ultrasound techniques may be employed:

• Contrast-enhanced ultrasound (CEUS): Though considered off-label during pregnancy, recent studies suggest CEUS may be safely used for non-obstetric conditions when benefits outweigh risks 3
• Bedside ultrasound: Increasingly available in emergency departments for rapid assessment of early pregnancy complications 1

Ultrasound remains the cornerstone of imaging during pregnancy due to its excellent safety profile, widespread availability, and ability to provide immediate results without exposing the mother or fetus to ionizing radiation.