Main Article Content

Ultrasound biosafety: Knowledge and opinions of health practitioners who perform obstetric scans in South Africa

Salome E. Mashiane
Barbara van Dyk
Yasmin Casmod


Background: Diagnostic ultrasound is generally considered as a safe test in pregnancy. To date
there is no evidence that ultrasound has caused harm to the developing foetus. However, with
the number of obstetric scans on the rise and the steep increase in acoustic output achieved by
modern machines, the lack of evidence of absolute safety remains a concern. Acoustic output
is under the direct control of the operator and is therefore the operator’s responsibility to keep
the intensity as low as reasonably achievable. A situation analysis in the South African context
was deemed necessary to determine end user knowledge and opinions on safe antenatal
ultrasound practice.
Aim: The aim of this quantitative descriptive, cross-sectional study was to evaluate the
knowledge and practice of health practitioners who perform antenatal scans regarding safety
aspects of diagnostic ultrasound.
Setting: A self-administered questionnaire was distributed at two national congresses, hosted
by the South African Society of Ultrasound and Obstetrics (SASUOG) and South African Society
of Obstetricians (SASOG) committees.
Method: Quota non-probability sampling allowed for the identification of professional
categories capable of providing information relevant to the study objectives. The sample
represented a population with experience in obstetric ultrasound.
Results: Compared to international studies, South African end users demonstrated better
knowledge of safety indices than their international counterparts. It is, however, discouraging
that end users still demonstrate insufficient knowledge regarding factors contributing to
adverse biological effects.
Conclusion: With room for improvement, an effort should be made to comply with
international standards through increased training efforts and raising awareness.
Keywords: Obstetric Ultrasound; Ultrasound Bio-Effects; Safety Indices and Principles;
Acoustic Output; Mechanical Index; Thermal Index; Teratogenic; ALARA.