Modern miracle

His mother-to-be beams with pride when she sees him kick his tiny, exquisitely formed feet -- her future football player, she says.

Tammi Kyne's due date is still months away, but getting a glimpse of her 28-week-old fetus through new three- and four-dimensional -- or "moving" -- ultrasound imagery was a thrill like no other.

It also comforted the McKeesport woman, who suffered a second-trimester miscarriage four years ago.

"It's beautiful to put a face with this person that's going to be in my life forever," said Kyne, 26, a Web site designer. "I wish he was here right now, but it's just nice to know he's OK."

Despite safety warnings from the U.S. Food and Drug Administration and medical organizations, Kyne is among the thousands of expectant parents nationwide flocking to keepsake ultrasound studios for a sneak peek at their unborn babies.

Last week she visited the first such center in the Pittsburgh area -- Insight Imaging Inc. in Monroeville.

"It's all about meeting and spending time with baby," said owner Henriette Clark, a registered diagnostic medical sonographer trained in fetal imaging.

Clark, 43, of Plum, worked at the former Citizens General Hospital in New Kensington, Westmoreland County, and taught ultrasound technology before launching her business in an office complex last summer.

She has conducted about 500 scans so far in her spa-like studio with dim lighting and soft music.

Each session lasts a half-hour, costs about $200 -- not covered by insurance -- and includes a video and color prints for parents to paste in baby books. Clients must be at least 27 weeks pregnant and have undergone a diagnostic ultrasound prescribed by a doctor.

The video images, projected on the wall during the scan, are meant to help parents begin bonding with their babies, not as a substitute for medical care, Clark said.

"I'm not going to answer medical questions, but I help parents find a new way to enjoy and celebrate their pregnancies," she said.

For more than 30 years, two-dimensional ultrasounds, called sonograms, have been a routine part of prenatal care. They convert reflected sound waves into electrical impulses a computer can process to create a picture of a developing fetus.

Scans typically occur in a doctor's office or hospital between 16 and 20 weeks into a pregnancy to determine the size, age and position of the baby; monitor fetal heartbeat, movement and breathing; and check for some birth defects, said Dr. Sanj Katyal, chief of ultrasound at West Penn Hospital in Bloomfield.

Medical technologists recently developed more advanced systems that create 3-D images of the fetus. The 4-D ultrasounds take these 3-D images and show them moving almost in real-time. The resulting pictures reveal such details as chubby cheeks and hair, and show fetuses sucking their thumbs or sticking out their tongues.

Doctors at West Penn and Magee-Womens Hospital in Oakland use this high-resolution imaging technology for diagnostic ultrasound and often share the images with parents. But they are critical of its nonmedical use at unregulated keepsake studios.

Ultrasound is a form of energy. Although there are no confirmed biological effects from prenatal ultrasound, problems could be identified in the future, Katyal said. This is especially true if women undergo elective scans for longer periods of time at higher energy levels than recommended, he said.

"One or perhaps two ultrasounds for the baby for medical reasons is fairly safe and well documented," Katyal said. "But nobody knows the long-term risk to the fetus of performing multiple scans."

The medical establishment agrees.

Doctors with the American Institute of Ultrasound in Medicine, the Society of Medical Diagnostic Sonography and the American College of Obstetricians and Gynecologists warn that ultrasound is a medical procedure, not a Kodak moment, and discourage patients from having sonograms for nonmedical reasons.

"Ultrasound is safe, and there's absolutely no evidence of harmful effects, but when it's used in a setting without medical supervision, that may be called into question," said Dr. David Kauffman, an internal fetal medicine specialist at Magee.

The prenatal portrait fad also raises other safety and ethical questions, Kauffman said. For example, what if a scan operator finds a suspected anomaly and isn't trained to interpret the image or counsel the parents? Or, what if an uninsured women depend on unregulated ultrasound centers instead of doctors?

The FDA considers making keepsake fetal videos an unapproved use of a medical device. The agency shut down several studios about 10 years ago.

Some state laws -- although not Pennsylvania's -- prohibit the use of an ultrasound machine without a prescription.

The California Assembly approved a bill earlier this month that would allow ultrasound machines to be sold only to licensed professionals. The legislation was introduced after actor Tom Cruise bought an ultrasound machine -- they cost about $100,000 -- to watch the fetus of his then-pregnant fiancee, Katie Holmes.

Clark, and many proponents, said the emotional benefits of using 3-D and 4-D ultrasound in a nonmedical setting outweigh any potential risks.

"But you have to ask questions," Clark said. "It's not like going to Target and having your baby's picture taken."

Kyne teared up when she saw her baby boy last week.

"It's very spiritual," said Kyne, holding her rounded belly. "Before I came and got these pictures done, I didn't feel much of a motherly bond. Now it's different."

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