Clinical perspective on diagnostic X-ray examinations of pregnant patients - What to take into account

Imaging during pregnancy has increased in frequency. Radiation protection is extremely important although tissue reactions of the conceptus, requiring a threshold dose of around 100mGy, are unlikely in the diagnostic use of X-rays and stochastic effects of cancerogenesis have a rather low risk (around 10^-4/mGy for childhood cancer due to in utero exposure). This article will review the risk depending on dose and phase of pregnancy and the exposure by frequent examinations; it will then concentrate on the duties of an imaging department: screening for pregnancy, examination justification, planning and optimization, patient information, counseling, involving the patient in the decisions, and managing the situation of pregnant staff members. Typical flowcharts of investigating frequent clinical questions will finally be presented and critically discussed.