The Health Ministry has made known that obstetricians and gynecologists should not charge for performing ultrasound in pregnant women, said Mohammad Aqajani, deputy minister of health for treatment.
“While they are allowed to use the ultrasound device only as auxiliary tool for regular monitoring of fetal growth, their tasks are completely different from that performed by radiologists.”
Ultrasound examination of pregnant women by obstetricians and gynecologists “has no legal validity, and the results cannot be reported to other doctors or registered in patient’s records,” he said, as reported by Salamat News website.
Ultrasound helps to look for the presence of a fetal heart beat, location of the pregnancy within the uterus and gestational period.
“No tariffs have been considered by the ministry for fetal ultrasound performed by obstetricians and gynecologists; however some violators charge $115 or more per 3D ultrasound examination,” said deputy head of Iran Society of Radiology (ISR), Dr Hussein Karampour.
Karampour also criticized ultrasound and radiology classes being held for obstetricians and gynecologists. “The ministry has issued permits for 60 perinatalogists to hold 3-day training workshops for them. Each participant should pay $2000 to attend.”
At the workshops, the basics of radiology are taught to obstetricians and gynecologists, he said, observing that such courses are not necessary for them and could overlap with the work of radiologists.
He further said when an imaging test is needed, many gynecologists don’t send their patients to radiologists. Instead, they take decisions after ultrasound diagnosis of a health complication.
Sometimes a wrong diagnosis (and also a missed diagnosis) can even result in miscarriage, he warned, while radiologists, who are medical doctors specializing in diagnosing and treating diseases and injuries using medical imaging techniques, such as x-rays, computed tomography (CT), magnetic resonance imaging (MRI), nuclear medicine, positron emission tomography (PET), can make accurate diagnosis.
Presently there are 3,200 radiologists across the country and an ultrasound examination for those covered by health insurance is $20.
Medically Unnecessary
Unfortunately some obstetricians and gynecologists take advantage of pregnant women’s ignorance or fears and concerns. A lot of pregnant women blindly follow their doctor’s advice and go for extra ultrasound scans without a clear medical need, because they think it may be necessary for their babies’ health.
International experts are now warning that frequent scans in low-risk pregnancies aren’t medically justified. A joint statement in May 2014 from several medical societies, including the American College of Obstetricians and Gynecologists, called for one or two ultrasounds in low-risk, complication-free pregnancies, while at present many women undergo routine ultrasound examinations.
As the US FDA warned in 2004, “ultrasound is a form of energy, and even at low levels, laboratory studies have shown it can produce a physical effect in the tissue, such as jarring vibrations and a rise in temperature.” This is consistent with research conducted in 2001 in which an ultrasound transducer aimed directly at a miniature hydrophone placed in a woman’s uterus recorded sound “as loud as a subway train coming into the station.”
A rise in temperature of fetal tissue especially since the expectant mother cannot even feel it might not seem alarming, but frequent temperature increases can cause significant damage to a developing fetus’s central nervous system, according to research.
