Fetal radiation exposure risk in the pregnant neurointerventionalist

The prevalence of women physicians is steadily rising, but the field of neurointervention remains one of the most male-dominated subspecialties in medicine. A fear of radiation exposure, particularly during pregnancy and childbearing years, may be responsible for deterring some of the best and brightest. This is the first study to examine the amount of maternal and fetal radiation exposure during a pregnant neurointerventional fellow's training.

We retrospectively analyzed the radiation exposure of a neurointerventional fellow prior to and during pregnancy from February 2018 to May 2019 in 758 neurointerventional cases. The collar dosimeter was used to measure overall maternal exposure and an additional fetal dosimeter was worn under two lead apron skirts to estimate fetal radiation exposure.

There was not a significant difference between pre- and post-pregnancy overall maternal radiation exposure as measured by the collar dosimeter (151 mrem pre-pregnancy and 105 mrem during pregnancy, p=0.129). Mean fluoroscopy time and fluoroscopy emission per procedure also did not differ prior to and during pregnancy. Fetal radiation exposure measurements from both the Mirion Genesis Ultra TLD dosimeter as well as the Mirion Instadose dosimeters worn under double lead apron skirts were 0 mrem for all 6 months.

These findings suggest that, when optimal radiation safety practices are implemented, the fetal dose of a pregnant neurointerventionalist is negligible. Further studies and education are necessary to encourage women to choose neurointervention and allow practicing women neurointerventionalists to maintain their productivity during their reproductive years.