Rio Grande Valley mothers-to-be

By David Robledo

Rio Grande Valley mothers-to-be flood Mexican towns in search
of cheap procedure that carries potentially expensive risks

Half a century has passed since scientists first applied the word autistic to children with severe social, communication, and behavioral problems. Research into autism’s prevalence soon followed – with early statistics estimating that 4 out of every 10,000 children were born autistic.
That early statistic has been shattered. Leading research now estimates that autism afflicts one out of every 166 children – with numbers rising. But recent research may be close to solidly establishing at least one cause of this affliction.
Autism is a developmental disability that appears during the first three years of life – a neurological disorder that affects the brain in areas that control verbal and non-verbal communication. Autistic children generally seem more withdrawn or erratically active, respond poorly to social cues, and exhibit learning difficulties early in childhood development.
Recent studies from Yale University, the University of Minnesota and other institutions, however, have drawn a connection between the use of sonograms and the type of brain cell displacement found in autistic children.
But throughout the country, clinics, gynecologists and prenatal portrait studios continue to use sonograms for purely aesthetic reasons, snapping a pre-birth picture or capturing an in-the-womb video – potentially dangerous keepsakes.
The Rio Grande Valley is no exception to the popularity of these vanity sonograms. Some local clinics even advertise free 3-D and 4-D ultrasound videos to attract expectant mothers to their care.
And, like Winter Texans seeking inexpensive medication or blue-collar families in search of affordable dental care, pregnant women are flooding the border towns of Mexico to undergo prenatal ultrasounds – often in tiny, ramshackle offices where intensity levels of ultrasound are unchecked by physicians who sometimes play no consulting role in the birth process.

DOING THE MATH
The research is so compelling that Joe Pennacchio, a Republican legislator in the New Jersey state assembly, used it to spearhead a campaign calling for stricter control on the use of sonograms to image fetuses.
One of the reports Pennacchio relied on, a 2005 report from Yale Medical School, shows that neural brain cell formation in autistic children shows the same pattern as mice exposed to varying degrees of sonograms.
The report – and similar studies coming from leading neurological research centers – can’t be conclusive. But it sets itself apart from other studies into the causes of autism, which often try to make connections between simple exposure of pregnant mothers to suspected toxins or conditions.
Dr. Philip A. Defina, chief neuropsychologist at New York University’s Brain Research Laboratory, said that the Yale analysis and other similar studies do more than establish a possible cause of autism — they establish a direct link.
“When brain cells are developing, they have to go to the right place for correct development of the brain,” DeFina told The Paper of South Texas last week.
“But the brain cells are being reorganized due to sound waves [from sonograms], which can create emotional problems, learning disabilities and autism,” he said.
DeFina, however, did say that sonograms might be just one in a cluster of possible causes of autism, and that more research is needed in that regard.
The New Jersey legislator Pennacchio said the Yale research and other inquiries are invaluable, and could help stem the rising tide of autism in the U.S. – a neurological phenomenon he described as “epidemic.”

MEXICAN DISCOUNT
Viagra, braces, penicillin, stomach tucks – the remedies and surgical procedures available to Rio Grande Valley residents on the streets of Mexico are almost endless.
Sometimes the risks are well known, but overlooked in exchange for a few saved dollars. Sometimes, however, the risks are impossible to fathom, as modern science slowly reveals the dangers of current medications and procedures.
Dr. Alberto Treviño Castillo is one of dozens of Mexican radiologists who rely on sonogram business from Rio Grande Valley residents for a living. Offices like his can be found in cities throughout northern Tamaulipas, clustering near clinics and hospitals.
The physician said in an interview with The Paper that Valley residents seek his radiology and sonogram services in Nuevo Progreso for a host of reasons – sometimes to help diagnose brain tumors or intestinal problems, or to locate broken bones.
Ninety percent of his patients are from the U.S. Of those he treats, the large majority are women in search of prenatal sonograms, he said.
Dr. Treviño, like most doctors, believes sonograms are safe. He said that he hasn’t heard of research that would connect autism with the use of sonograms.

PRESENT POLICIES
The U.S. Food and Drug Administration also considers the use of sonograms relatively safe, although the agency does recommend that sonograms be used only when there is a medical necessity. The administration does, however, warn against the “unknown” risks of repeatedly exposing a fetus to ultrasound.
“As compelling as (ultrasound) sneak previews may be, the FDA is warning women about the potential hazards of getting keepsake videos,” the agency says in a recent report. “The long-term effects of repeated ultrasound exposures on the fetus are not fully known.”
Insurance companies and government-funded medical assistance programs consider sonograms safe, and offer coverage for the procedure in cases of medical necessity.
But physicians who recognize the dangers of sonograms to unborn children say the definition of “medical necessity” is far too broad, and too many women receive unnecessary ultrasound imaging throughout their pregnancies.
In the case of women who seek sonograms in Mexico, the lack of necessity is way out of hand, said Nivea Fisch, a nurse and midwife with Harlingen Obstetrics and Gynecology Associates.
Fisch is one of the few local medical personnel who advocate against the use of sonograms in most pregnancies, although she does support the use of sonograms in certain cases when the fetus or mother is in danger.
Fisch said that most U.S. doctors limit the scans to two or three in a pregnancy, but women who use sonogram services in Mexico sometimes will get one or more per month. At about $20 each, sonograms in Mexico are cheaper than their approximately $300 U.S. counterparts, and they’re easier to schedule than the same procedure in the U.S.

ANOTHER THEORY, SAME PROBLEM
Dr. Chris Johnson, a leading researcher in autism detection from San Antonio, said that one possible reason for the rising ratio of children born with autism is simply that the condition is tested for at a higher rate.
“It probably relates to a number of factors, including broader criteria, increasing professional and public awareness of the symptom spectrum, better ascertainment and perhaps a true rise in prevalence,” she said.
For parents of autistic children, the possible link between autism and sonograms has the ring of other warnings too numerous to count.
Missy Renaud, board member of a burgeoning local autism support group and mother to two autistic children, said that she’s read so many reports linking autism to environmental factors, there’s no way to make sense of the alleged risks.
“If you pay attention to all the warnings, and all the claims about the cause of autism, you have to shut down completely,” Renaud said.
Renaud said that she went through minimal use of sonograms – about two per child. But, even if there is a link between autism and ultrasound, there’s plenty of other work to be done.
With reported autism cases skyrocketing, Renaud and parents like her focus on helping children with the condition live full lives, and educating the public about autistic children’s potential. But without serious allocation of resources to learn the causes, Renaud thinks that the U.S. – the Rio Grande Valley included – could be facing a severe educational challenge that will characterize an entire generation in a way that has never before been seen. •