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Diagnostic radiography in pregnancy: risks and reality
1Department of Medicine, Royal Hospital for Women, New South Wales, Randwick, Sydney, Australia. s.lowe@unsw.edu.au
Summary
Diagnostic radiation during pregnancy generally poses minimal risk to the fetus. Most imaging procedures result in low fetal absorbed doses, with a very small increase in childhood malignancy risk only at higher exposures.
Area of Science:
- Radiology
- Medical Imaging
- Radiation Oncology
Background:
- Diagnostic imaging (X-rays, CT, nuclear medicine) in pregnant women causes significant patient and physician anxiety.
- Concerns exist regarding potential adverse effects of diagnostic radiation on the fetus.
Purpose of the Study:
- To review the literature on adverse effects of diagnostic radiation in pregnancy.
- To determine fetal absorbed doses from medical imaging.
- To assess the influence of exposure timing and administration on these effects.
Main Methods:
- Comprehensive literature review of relevant databases and institutional protocols.
- Sought data on diagnostic radiation adverse effects, fetal absorbed dose, and influencing factors.
Main Results:
- Fetal absorbed doses are typically <1 mGy (non-abdominal/pelvic imaging) or <10 mGy (abdominal/pelvic/nuclear medicine).
- Potential risks include teratogenicity, genetic damage, intrauterine death, and malignancy; however, only a slight increase in childhood malignancy is statistically proven at diagnostic levels.
- Fetal thyroid is a risk from radioiodine exposure after 12 weeks' gestation.
Conclusions:
- Diagnostic radiography during pregnancy, excluding high-dose abdominal/pelvic procedures, is not linked to significant adverse events.
- Counseling should emphasize the minimal impact of most diagnostic procedures based on human data.