(Some of the references were added to the text during revision, explaining their out-of-order appearance in the text; I don’t have the energy to redo the whole lot, and would almost certainly make a systemic mistake that would add confusion)

NB.  At the time of writing it is possible to get full-text access to the Journal of Ultrasound in Medicine for a month for $25.  Free abstracts are available anyway.  For a given reference google JUM, then go to Quick Search, enter volume (number given after year of publication) and first page number.

1.  American Institute of Ultrasound in Medicine.  Bioeffects literature reviews.  Journal of Ultrasound in Medicine 2004; 23:1535-1542 (for acoustic intensity values for the ADR 2130 see pages 1535-1536)

2.  Fatemi M, Ogburn PL Jr, Greenleaf JF.  Fetal stimulation by pulsed diagnostic ultrasound.  Journal of Ultrasound in Medicine 2001; 20:883-889 (for acoustic intensity values for the Acuson 128xp see pages 884-885).

3.  Kremkau FW.  Technical Topics: Sound Levels.  Journal of Ultrasound in Medicine, Reflections Section R30-31, May 1983

4.  Sheiner E, Freeman J, Abramowicz JS.  Acoustic output as measured by mechanical and thermal indices during routine obstetric ultrasound examinations.  Journal of Ultrasound in Medicine 2005; 24:1665-1670
Medline abstract

5.  Willis CE, Slovis TL. The ALARA concept in pediatric CR and DR: Dose reduction in pediatric radiographic exams – a White Paper Conference.  American Journal of Roentgenology 2005; 184:373-374 (see recommendation 7)

6.  http://ortho.smith-nephew.com/us/node.asp?NodeId=2865 
     Select EXOGEN* mechanism of action

7.  http://www.smithnephew.com/US/Standard.asp?NodeId=3360 

8.  Heybeli N, Yesildag A, Oyar O et al.  Diagnostic ultrasound treatment increases the bone fracture-healing rate in an internally fixed rat femoral osteotomy model.  Journal of Ultrasound in Medicine 2002; 21:1357-1363

9. U.S. Department of Health and Human Services, Food and Drug Administration Center for Devices and Radiological Health:  Information for Manufacturers Seeking Market Clearance of Diagnostic Ultrasound Systems.  Accessible at http://www.fda.gov/cdrh/ode/ulstran.pdf : (page numbers at bottom of each page)
9a. Page 3-2
9b. Page 3-5
9c. Page 6-1, introductory paragraph section 6
9d. Page 6-2

10.  Ang ESBC Jr, Gluncic V, Duque A et al.  Prenatal exposure to ultrasound waves impacts neuronal migration in mice.  Proceedings of the National Academy of Sciences 2006; 103: 12903-12910 (Open access article online – Aug 22, 2006)
http://www.pnas.org/cgi/content/full/103/34/12903

11.  Malone FD, Canick JA, Ball RH et al.  First-trimester screening or second-trimester screening, or both, for Down’s syndrome.  New England Journal of Medicine 2005; 353:2001-11

12.  Caviness VS, Grant PE.  Our unborn children at risk?   Proceedings of the National Academy of Sciences 2006; 103: 12661-12662 (not open access online)

13.  Alexandrov AV, Molina CA, Grotta JC et al.  Ultrasound-enhanced systemic thrombolysis for acute ischemic stroke.  New England Journal of Medicine 2004; 351:2170-2178 
Medline abstract

14.  Polak JF.  Ultrasound energy and the dissolution of thrombus.  New England Journal of Medicine 2004; 351: 2154-2155

15. Health Canada. Guidelines for the Safe Use of Diagnostic Ultrasound 2001.   Accessible at http://www.hc-sc.gc.ca/ewh-semt/pubs/radiation/01hecs-secs255/rec_e.html
15a. Section 2.4
15b. Section 2.3

16.  O’Brien WD Jr., Abbott JG, Stratmeyer ME et al.  Acoustic output upper limits proposition: should upper limits be retained?  Journal of Ultrasound in Medicine 2002; 21:1335-1341

17.  AIUM Clinical Standards Committee.  AIUM Technical Bulletin.  How to interpret the ultrasound output display standard for higher acoustic output diagnostic ultrasound devices: Version 2.  Journal of Ultrasound in Medicine 2004; 23:723-726

18.  http://www.cdc.gov/DES/consumers/about/history.html

19.  http://www.desaction.org/

20.  Abramowicz JS.  Ultrasound in obstetrics and gynecology; is this hot technology too hot?  Journal of Ultrasound in Medicine 2002; 21:1327-1323

21.  Toms DA.  The mechanical index, ultrasound practices, and the ALARA principle.  Journal of Ultrasound in Medicine 2006(April); 25:560-561

22.  Abramowicz JS, Sheiner E.  Acoustic output in obstetric ultrasound, ALARA and education.  Journal of Ultrasound in Medicine 2006(April); 25: 561-562

23.  National Research Council of the National Academies, Committee to Assess Health Risks from Exposure to Low Levels of Ionizing Radiation:  Health Risks from exposure to low levels of ionizing radiation. Biological Effects of Ionizing Radiation – BEIR VII Phase 2.  2006, National Academies Press. Washington DC www.nap.edu

24.  Radiological Society of North America.  RSNA News October 2006, volume 16, number 10.  Question and answer pages 1 and 12   

25.  Pretorius DH, Gattu S, Eun-Kyung Ji at al.  Preexamination and postexamination assessment of parental-fetal bonding in patients undergoing 3-/4-Dimensional obstetric ultrasonography.  Journal of Ultrasound in Medicine 2006(November); 25: 1411-1421
(Original study plus review)
    
 
26.  Benacerraf BR, Shipp TD, Bromley B.  How sonographic tomography will change the face of obstetric sonography: a pilot study.  Journal of Ultrasound in Medicine 2005; 24: 371-378 
Medline abstract

27.  http://www.cochrane.org/reviews/en/ab000182.html

28.  Toms DA.  The case against routine obstetrical ultrasound.  Annals of the Royal College of Physicians and Surgeons of Canada 1984; 17:225-229
(The publication is no longer in existence)

29.  Malone PS.  Antenatal diagnosis of renal tract anomalies: has it increased the sum of human happiness?  Journal of the Royal Society of Medicine 1996; 89: 155-158

30.  http://news.bbc.co.uk/2/hi/south_asia/4855682.stm

31.  Afterthought “reference”:  A data sheet I obtained around 1984 for “ABSOLUTE MAXIMUM ULTRASOUND EMISSIONS:  ADR TRANSDUCERS” provides an interesting perspective on output evolution.  To clarify some information extracted from this sheet given below: I am reasonably certain that the 3.5 AA was the common initial linear probe and the 13mm EFT was a mechanical sector added to the product line later.  POWER refers to the total acoustic power emitted, SPTA to the (spatial-peak) time-averaged intensity and SPTP to (spatial-peak) temporal-peak intensity i.e. the pulse peak intensity.  While SPTP is usually given in W/cm2, on this sheet it is given in mW/cm2.  Values are for standard B-mode imaging.  Whatever the shortcomings of the measurement methodology were at that time it was presumably consistent, making the results comparable.  An approximately 300-fold increase in intensity is noted; this is before the major increase in regulatory limits.  The information thus provides support for the impression that there has been a 1000-fold increase from around 1980 to the late 1990’s.

32.  I assume that the 1995 value for Ispta for the Acuson 128xp  in reference 2 is derated.  Even if is not, and were to be reduced fourfold to allow for attenuation before reaching a human fetus, it would still be much larger than 0.6 mW/cm2

33. Sheiner E, Shoham-Vardi I, Abramowicz JS.  What do clinical users know regarding safety of ultrasound during pregnancy?  Journal of Ultrasound in Medicine 2007; 26:319-325

34.  Eggers J, Konig IR, Koch B, Handler G, Seidel G.  Sonothrombolysis with transcranial color-coded sonography and recombinant tissue-type plasminogen activator in acute middle cerebral artery main stem occlusion.  Stroke.  2008; 39:1470-1475
 
35.   Abramowicz JS, Fowlkes JB, Skelly AC, Stratmeyer ME, Ziskin MC.  Conclusions regarding epidemiology for obstetric ultrasound.  Journal of Ultrasound in Medicine  2008; 27:637-644
 
36.  Stratmeyer ME, Greenleaf JF, Dalecki D, Salvesen KA.  Fetal Ultrasound: Mechanical effects.  Journal of Ultrasound in Medicine.  2008; 27:597-605
 
37.  Gluckman PD, Hanson MA, Cooper C, Thornburg KL.  Effect of in utero and early-life conditions on adult health and disease.  New England Journal of Medicine.  2008; 359:61-73