Timing of MRI in pregnancy, repeat exams, access, and physician qualifications

This review addresses specific questions regarding performance and utility of fetal MR. The specific issues addressed are (1) physician qualifications; (2) MR safety; (3) access to fetal MR; (4) timing of MRI in pregnancy; (5) repeat exams; and (6) when MRI is most effective for prenatal diagnosis. Fetal MRI is a problem-solving tool used for specific indications that are driven by ultrasound or at times by family history. Fetal MR should always be performed with knowledge of the sonographic findings from prior targeted scan. The best evidence for utility of MR is in assessment of CNS anomalies and assessment of the fetus with airway obstruction requiring decisions regarding mode of therapy. The type of information provided by MR can profoundly impact patient counseling and management. We recommend a team approach including specialists in obstetric imaging, fetal MRI, and postnatal care in interpreting MR so that the best information can be given to the pregnant patient.