Are keepsake 3D ultrasounds safe?

What does the evidence say about keepsake 3D ultrasounds during pregnancy?

1. Obstetric ultrasound machines display a real-time thermal index and mechanical index while scanning, and the safety threshold used in daily practice is keeping both at or below 1.0, following the As Low As Reasonably Achievable (ALARA) principle; one study found about 20% of credentialed operators exceeded a thermal index of 1.0 during scans, with some readings as high as 1.6. 1
2. The FDA raised the maximum allowed ultrasound energy output in 1992 to a level theoretically capable of raising fetal tissue temperature by about 2 degrees Celsius, which is part of why professional guidance emphasizes that fetal ultrasound exams should be performed only when clinically indicated, by trained personnel, following the ALARA principle. 1
3. The FDA has warned that commercial keepsake ultrasound videos are often performed by untrained operators and can involve exposures lasting up to an hour, compared with a focused medical exam, and that modern equipment can produce ultrasound intensities several times higher than machines used a decade earlier; the American Institute of Ultrasound in Medicine has said it strongly discourages non-medical ultrasound use for entertainment purposes. 2
4. A systematic review of the ethics of prenatal ultrasound found that entertainment-focused scans tend to involve increased exposure time, and that providers in non-clinical, non-medical settings aren't positioned to counsel a family if a scan happens to show a possible fetal abnormality, which can create either false reassurance or unwarranted alarm. 3
5. On the reassuring side, a National Institutes of Health-funded study of serial pregnancy ultrasounds found no consistent link between scans where the thermal or mechanical index exceeded 1.0 and differences in birth weight, head circumference, or body length, which the authors say offers some reassurance for clinically-indicated repeat imaging at current safety thresholds. 4

Is keepsake 3D ultrasounds safe in each trimester?

• First trimester. Elective 3D/4D keepsake scans aren't typically marketed for the first trimester, since there isn't yet enough to see in a recognizable way. Any ultrasound done now should be a medically-indicated one, like dating or an early anatomy check, not an entertainment session.
• Second trimester. This is when most keepsake studios book appointments, since there's enough fetal development to produce a recognizable 3D image. If you want a keepsake photo, asking the technician at your own medically-indicated ultrasound to save an image or video avoids the extra, non-clinical session altogether.
• Third trimester. Keepsake sessions are also marketed in the third trimester. The same guidance applies regardless of timing: professional societies would rather any additional imaging be part of care your provider has already recommended, not a separate elective visit.