The invention: A medically safe alternative to X-ray examination, ultrasound uses sound waves to detect fetal problems in pregnant women.
The people behind the invention:
Ian T. Donald (1910-1987), a British obstetrician
Paul Langevin (1872-1946), a French physicist
Marie Curie (1867-1946) and Pierre Curie (1859-1906), the
French husband-and-wife team that researched and
developed the field of radioactivity Alice Stewart, a British researcher
An Underwater Beginning
In the early 1900′s, two major events made it essential to develop an appropriate means for detecting unseen underwater objects. The first event was the Titanic disaster in 1912, which involved a largely submerged, unseen, and silent iceberg. This iceberg caused the sinking of the Titanic and resulted in the loss of many lives as well as valuable treasure. The second event was the threat to the Allied Powers from German U-boats during World War I (1914-1918). This threat persuaded the French and English Admiralties to form a joint committee in 1917. The Anti-Submarine Detection and Investigation Committee (ASDIC) found ways to counter the German naval developments. Paul Langevin, a former colleague of Pierre Curie and Marie Curie, applied techniques developed in the Curies’ laboratories in 1880 to formulate a crude ultrasonic system to detect submarines. These techniques used beams of sound waves of very high frequency that were highly focused and directional.
The advent of World War II (1939-1945) made necessary the development of faster electronic detection technology to improve the efforts of ultrasound researchers. Langevin’s crude invention evolved into the sophisticated system called “sonar” (sound navigation ranging), which was important in the success of the Allied forces. Sonar was based on pulse echo principles and, like the system called “ra-dar” (radio detecting and ranging), had military implications. This vital technology was classified as a military secret and was kept hidden until after the war.
Ian Donald
Ian Donald was born in Paisley, Scotland, in 1910 and educated in Edinburgh until he was twenty, when he moved to South Africa with his parents. He graduated with a bachelor of arts degree from Diocesan College, Cape Town, and then moved to London to study medicine, graduating from the University of London in 1937. During World War II he served as a medical officer in the Royal Air Force and received a medal for rescuing flyers from a burning airplane. After the war he began his long teaching career in medicine, first at St. Thomas Hospital Medical School and then as the Regius Professor of Midwifery at Glasgow University. His specialties were obstetrics and gynecology.
While at Glasgow he accomplished his pioneering work with diagnostic ultrasound technology, but he also championed laparoscopy, breast feeding, and the preservation of membranes during the delivery of babies. In addition to his teaching duties and medical practice he wrote a widely used text topic, oversaw the building of the Queen Mother’s Hospital in Glasgow, and campaigned against England’s 1967 Abortion Act.
His expertise with ultrasound came to his own rescue after he had cardiac surgery in the 1960′s. He diagnosed himself as having internal bleeding from a broken blood vessel. The cardiologists taking care of him were skeptical until an ultrasound proved him right. Widely honored among physicians, he died in England in 1987.
An Alternative to X Rays
Ian Donald’s interest in engineering and the principles of sound waves began when he was a schoolboy. Later, while he was in the British Royal Air Force, he continued and maintained his enthusiasm by observing the development of the anti-U-boat warfare efforts. He went to medical school after World War II and began a career in obstetrics. By the early 1950′s, Donald had em-
Safe and not requiring surgery, ultrasonography has become the principal means for obtaining information about fetal structures. (Digital Stock)
barked on a study of how to apply sonar technology in medicine. He moved to Glasgow, Scotland, a major engineering center in Europe that presented a fertile environment for interdisciplinary research. There Donald collaborated with engineers and technicians in his medical ultrasound research. They used inanimate and tissue materials in many trials. Donald hoped to apply ultrasound technology to medicine, especially to gynecology and obstetrics, his specialty.
His efforts led to new pathways and new discoveries. He was interested in adapting a certain type of ultrasound technology method (used to probe metal structures and welds for cracks and flaws) to medicine. Kelvin Hughes, the engineering manufacturing company that produced the flaw detector apparatus, gave advice, expertise, and equipment to Donald and his associates, who were then able to devise water tanks with flexible latex bottoms. These were coated with a film of grease and placed into contact with the abdomens of pregnant women.
The use of diagnostic radiography (such as X rays) became controversial when it was evident that it caused potential leukemias and other injuries to the fetus. It was realized from the earliest days of radiology that radiation could cause tumors, particularly of the skin. The aftereffects of radiological studies were recognized much later and confirmed by studies of atomic bomb survivors and of patients receiving therapeutic irradiation. The use of radiation in obstetrics posed several major threats to the developing fetus, most notably the production of tumors later in life, genetic damage, and developmental anomalies in the unborn fetus.
In 1958, bolstered by earlier clinical reports and animal research findings, Alice Stewart and her colleagues presented a major case study of more than thirteen hundred children in England and Wales who had died of cancer before the age of ten between 1953 and 1958. There was a 91 percent increase in leukemias in children who were exposed to intrauterine radiation, as well as a higher percentage of fetal death. Although controversial, this report led to a reduction in the exposure of pregnant women to X rays, with subsequent reductions in fetal abnormalities and death.
These reports came at a very opportune time for Donald: The development of ultrasonography would provide useful information about the unborn fetus without the adverse effects of radiation. Stewart’s findings and Donald’s experiments convinced others of the need for ultrasonography in obstetrics.
Consequences
Diagnostic ultrasound first gained clinical acceptance in obstetrics, and its major contributions have been in the assessment of fetal size and growth. In combination with amniocentesis (the study of fluid taken from the womb), ultrasound is an invaluable tool in operative procedures necessary to improve the outcomes of pregnancies.
As can be expected, safety has been a concern, especially for a developing, vulnerable fetus that is exposed to high-frequency sound. Research has not been able to document any harmful effect of ultra-sonography on the developing fetus. The procedure produces neither heat nor cold. It has not been shown to produce any toxic or destructive effect on the auditory or balancing organs of the developing fetus. Chromosomal abnormalities have not been reported in any of the studies conducted.
Ultrasonography, because it is safe and does not require surgery, has become the principal means for obtaining information about fetal structures. With this procedure, the contents of the uterus—as well as the internal structure of the placenta, fetus, and fetal organs—can be evaluated at any time during pregnancy. The use of ultrasonography remains a most valued tool in medicine, especially obstetrics, because of Donald’s work.
See also Amniocentesis; Birth control pill; CAT scanner; Electrocardiogram; Electroencephalogram; Mammography; Nuclear magnetic resonance; Pap test; Sonar; Syphilis test; X-ray image intensifier.
