To the chagrin of some in sonography, that fickle entity known as consumer demand is also luring sonography into a new realm: fetal entertainment ultrasound scanning.

Also known as "keepsake" ultrasound scans, these typically consist of high-resolution 3D and 4D images of the developing fetus. As profit-making facilities pop up in strip malls across the country to provide these scans, mothers-to-be are jumping at the chance to see their unborn babies before delivery date.

Many sonographers and the FDA, however, aren't as keen on the idea-or the impact it might have on the modality. Some fear the trend's potentially adverse impact on the modality's reputation, not to mention the potential hazards that might accompany the performance of a sonogram by an inexperienced and/or uncertified operator. Since entertainment ultrasound scans aren't intended to be diagnostic, the persons performing them often aren't qualified to recognize or inform parents-to-be of any problems with the fetus, according to the FDA's own webpage on keepsake ultrasound scans. (For more information, visit www.fda.gov.

"It's giving sonography a bad name," Terry DuBose, MS, RDMS, FSDMS, FAIUM, said bluntly. DuBose is director of the diagnostic medical sonography program at the University of Arkansas for Medical Sciences, Little Rock, Ark. "One place in North Carolina offers "intensive" two-week training programs, which means they don't have a clue what they're doing. We need people who actually know what they're doing so when there is an anomaly they know what they're doing."

Martha Morgan, president of Little Sprout Imaging, a non-medical fetal imaging center in Towson, Md., argues that many facilities like hers are committed to addressing the concerns of the FDA and the AIUM.

"We only employ RDMS (OB) sonographers, and they are familiar with the general fetal anatomy in a 2D setting," Morgan explained. "If they do not have prior 3D/4D experience, they work with a staff sonographer to learn the new technology."

Morgan said she implemented an "Image is Everything" educational campaign " . in an effort to inform those seeking 3D sonograms that all 3D centers are not created equal." She said her employees follow a strict set of procedures when performing sonograms to ensure the safety of the mother and her unborn baby.

Brian S. Garra, MD, meanwhile, suggested that obstetricians and sonographers consider finding creative ways to compete with the companies that provide keepsake ultrasound scans. Currently most obstetricians don't offer them because insurance companies won't cover the extra images or the extra exam time.

"I expect that this will continue to increase, and you don't want to give them (keepsake ultrasound companies) a competitive advantage," said Dr. Garra, a radiology professor at the University of Vermont/Fletcher Allen Health Care in Burlington, Vt. "If a major medical center offers the same service, then people would probably rather go somewhere that assures quality. That hasn't happened yet, but I can see it happening with the proliferation of small ultrasound machines."

Stacy Stanislaw is the editorial assistant at ADVANCE. She can be reached at sstanislaw@merion.com.