Ultraschall in der Geburtshilfe: Kann der Fötus die Ultraschallwelle hören und die Hitze spüren?

Abstract

"Fetuses can hear ultrasound and the sound is as loud as a subway train entering a station." This statement originates in a single report in a non-peer reviewed journal, despite its name 1, of a presentation at a scientific meeting by researchers who reported measuring the sound intensity in the uterus of pregnant women and being able to demonstrate the above. This was later published in a peer-review journal 2 probably not very widely read by clinicians or the general public. From time to time, the popular press or various pregnancy-related websites repeat the assertion or a worried pregnant patient inquires about the truthfulness of this statement. A second, oft-quoted concern is that ultrasound leads to heating of the amniotic fluid. These two assertions may be very concerning to expectant parents and merit scientific scrutiny. In this editorial, we shall examine the known facts about the physical properties of ultrasound as they relate to these two issues. Diagnostic ultrasound employs a pulsed sound wave with positive and negative pressures and the Mayo team, quoted in the New Scientist, predicted that the pulsing would translate into a "tapping" effect 1. According to their report, they placed a tiny hydrophone inside a woman's uterus while she was undergoing an ultrasound examination. They stated that they picked up a hum at around the frequency of the pulsing generated when the ultrasound is switched on and off. The sound was similar to the highest notes on a piano. They also indicated that when the ultrasound probe was pointed right at the hydrophone, it registered a level of 100 decibels, as loud as a subway train coming into a station. Sound levels in decibels are defined for audible frequencies with the reference level being the threshold for hearing at a given frequency. Although the operating frequencies used in sonography are inaudible, it is possible for the pulsing rate (pulse repetition frequency, PRF) to be heard, thus falling in the audible range. A previous report had hinted at similar phenomena 3.Ultrasound is a pressure wave with a frequency beyond (ultra) that detectable in the human auditory system. The human ear can discern sound at roughly 20 - 20 000 cycles (hertz) per second. The frequencies of diagnostic ultrasound are roughly 1 - 10 megahertz (MHz) or 1 000 000 to 10 000 000 cycles per second. It is a form of energy and, as such, may have effects in tissues it traverses. Any consequences occurring in living tissues secondary to an external influence are called biological effects or bioeffects. This term does not imply damage or harm. The two major mechanisms for bioeffects are thermal and non-thermal. Thermal effects are secondary to ultrasound energy being converted into heat in the tissue (indirect effect of ultrasound) and non-thermal effects are secondary to the alternating positive and negative pressures generated by the wave (direct effect). The definition of moderately loud sound is 60 - 70 dB (2 × 10-3-2 × 10-2 Pa), defined as high urban ambient sound, normal conversation at...

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