Fetal radiation dose in prophylactic uterine arterial embolization
Anna-Leena Manninen1, Kati Ojala, Miika T Nieminen
1Department of Diagnostic Radiology, Oulu University Hospital, POB 50, 90029, Oulu, Finland, anna-leena.manninen@ppshp.fi.
Purpose:
The purpose of the study was to estimate the absorbed dose (AD) to the fetus for pregnant patients with placenta accreta undergoing fluoroscopy imaging during prophylactic catheterization and uterine artery embolization. We hypothesize that after optimizing the use of the radiation, this endovascular method is safe.
Methods:
Catheterization was performed for seven women before their elective cesarean section. The correct position of the catheter was confirmed by a radiologist using a small bolus of contrast medium and optimized pulsed fluoroscopy imaging. For the AD measurements of the fetus, four radiophotoluminescence dosimeters were placed in the vaginal fornix. Dose area product (DAP), entrance skin exposure (ESE), fluoroscopy time (Tf), and dose rate also was recorded.
Results:
The mean values of the radiation exposure for the seven patients were as follows: AD in the vaginal fornix was 11.2 (range 2.2-28.7) mGy, DAP 1,122 (648-2,001) cGy cm(2), ESE 120 (63-184) mGy, Tf 7:31 (5:05-11:35) min:sec, and dose rate 15 (8-21) mGy/min, respectively.
Conclusions:
This study revealed that the AD to the fetus due to the endovascular method can be reduced to be below the risk for developmental disorders when pulsed fluoroscopy with an optimized protocol is used without angiography exposures.
