MRI and pregnancy?
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MANAGING PREGNANT PATIENTS WHO ARE IRRADIATED
Relative agreement exists on when to recommend termination of pregnancy after radiation exposure. The so-called "Danish rule" was offered surrounded by 1959 by Hammer-Jacobsen, who suggested termination was advisable for a fetal dose of over 10 rads [1]. This guideline have been widely followed. Wagner et al suggest termination should individual be considered if a radiation dose of over 5 rad occurs between 2 and 15 weeks of gestation, and is probably indicated just for doses over 15 rad. Hall suggests termination may be considered for a radiation of over 10 rad received between a gestational age of 10 days and 26 weeks [2]. In practice, it is exceptionally unlikely that any single radiological study would deliver a radiation dose sufficient to justify termination. Nonetheless, it is considerate to be aware of the expected radiation dose from common procedures [3, 4], and the size of risk to the fetus per unit dose. This information, which is programmed below, can be used to counsel pregnant patients who require a study involving ionizing radiation to the pelvis, or who inadvertently undergo such a study at a time when pregnancy is unsuspected.
Procedure
Conceptus radiation dose (rads*)
Abdominal radiograph
0.25
Intravenous pyelogram
0.8
Barium enema
0.8
Lumbar spine radiographs
0.6
CT pelvis
1-10
Note: 1 rad = 1 cGy = 10 mGy = 10,000 uGy
Key point: In practice, it is exceptionally unlikely that any single diagnostic radiological study would deliver a radiation dose sufficient to prove right termination.
References
Hammer-Jacobsen E. Therapeutic abortion on account of x-ray nouns during pregnancy. Danish Med Bull 1959; 6: 113-122.
Hall EJ. Radiobiology for the radiologist, 4th ed. Philadelphia: Lippincott; 1994: 363-452.
Wagner LK, Archer BR, Zeck OF. Conceptus dose from two state-of-the-art CT scanners. Radiology 1986; 159: 787-792.
Bushberg JT, Seibert JA, Leidholdt EM, Boone JM. The essential physics of medical imaging. Williams and Wilkins, Baltimore, 1994; 694