High hopes held for ultrasound use

Press, 25 July 1985, Page 39

High hopes held for ultrasound use

NZPA-AAP Sydney Surgeons using ultrasound technology believe they will be able to open up the womb and perform surgery on serious foetal abnormalities within five years. Ultrasound — the use of sound waves to produce pictures of body organs and their soft tissue environment — has already been used successfully in Sydney to save the life of an unborn baby threatened with heart failure. In what is believed to be a world first, doctors at the Royal Hospital for Women, in Sydney, recently used ultrasound to diagnose a cyst on the lung of a 20-week-old foetus and to guide needles used to empty the cyst and relieve pressure on the heart. Dr William Garrett, director of medical imaging at the hospital and a world pioneer in this field, announced the breakthrough to an international gathering of ultrasound experts in Sydney. There have only been 55 registered ultrasound operations on unborn babies in the world and only four or five in Australia. Most “correctable” abnor-

malities, Dr Garrett said, would make themselves obvious during the pregnancy and obstetricians would advise screenings. Once the ultrasound has diagnosed an abnormality, doctors can change the outcome of the pregnancy. They can deliver the baby earlier, be prepared to operate immediately after birth, or advise termination. Doctors used ultrasound to diagnose an abnormality and to guide them during surgery, otherwise they would be “stabbing blindly,” Dr Garrett said. Both mother and unborn child are partly sedated so they are relaxed and feel little or no pain. Another researcher in this field. Dr Fred Lomas of Canberra, said the operation was done with needles, so there would be no more pain than an injection, though the mother might feel some pushing and pulling. Ultrasound operations have generally been done only to correct very rare abnormalities; the real gains from the improved technology is in giving the obstetrician and mother much more information about the pregnancy.

While doctors maintain that ultrasounds are safe — Dr Garrett said there had been no confirmed reports of harmful effects on the patient at a diagnostic level — they do not advocate universal screening for all pregnant women. Dr Lomas said babies who had undergone surgery straight after birth had been ready to go home after 10 days, compared with three months in intensive care if they arrived with an unsuspected abnormality. From research being done now in America, doctors believe they may soon be able to open the womb and perform major surgery on the foetus. This has been impossible in the past because the womb tends to contract and expel its contents after being opened. If research is successful, surgery could be done to correct such conditions as defects in the diaphragm which allow the intestines to work their way into the chest and cause problems with the lungs and heart.