[Imaging tests for the diagnosis of dyspnea during pregnancy]

Dyspnea during pregnancy may be due to cardiopulmonary disease (pleural effusion, pneumonia, pulmonary embolism, acute pulmonary oedema, asthma). Investigation requires thoracic imaging which is available in current practice. Given the risk of fetal malformation when radiation level exceeds 100mGy, clinical practices are heterogeneous. The choice of thoracic imaging for pregnant women also needs to take into account the level of ionizing radiation absorbed by the mother and the risk of radiation-induced cancer. In order to limit the number of potentially irradiating tests, it is essential to use non-irradiating thoracic imaging, to implement well-defined diagnostic strategies as first-line approaches and, more particularly, to apply imaging protocols adapted to the physiology of the pregnant patient. While thoracic imaging with ionizing radiation during pregnancy is not contraindicated, it must be clearly justified, and given the risks of fetal malformations and maternal cancer induced by radiations, it behooves clinicians to take into full account the benefit-risk balance and, as a rule, to apply the precautionary principle.