Medical radiodiagnosis and pregnancy: evaluation of options when pregnancy status is uncertain

There are 4 options available to the referring physician in considering radiodiagnostic examinations of patients with uncertain pregnancy status. In the first option, the referring physician in consultation with the radiologist may elect to perform a complete or modified examination, based on a complete evaluation of the risks and benefits of the procedure. Risks, in this case, would include the possibility of irreparable damage to an unsuspected conceptus. In the second option, the referring physician may cancel the examination altogether. In the third option, the referring physician may perform a pregnancy test before the examination to screen for the patients who are actually pregnant. The fourth option is to postpone the examination to the first half of the menstrual cycle when it is relatively certain that the patient is not pregnant (elective scheduling). The last 2 options are recommendations designed to minimize the occurrence of radiation exposures in unsuspected pregnancies. Using cost/benefit analysis and simple probability calculations, it is shown that, as general public policy, pregnancy tests and elective scheduling procedures are of little value and that the first 2 options are sufficient in deciding to perform the radiodiagnostic examination.