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There is a constantly evolving knowledgebase regarding the safety of MRI in pregnant patients, as well as the safety of gadolinium administration, given potential fetal risks. This review provides an overview of national and international recommendations for patient screening and safety by trimester, evaluates the most recent literature regarding administration of gadolinium in pregnant patients, and discusses technical requirements when imaging pregnant patients. A protocol for imaging pregnant patients is provided, and multiple common indications for MRI in pregnancy are discussed. Level of Evidence 5. Technical Efficacy Stage 5. J. Magn. Reson. Imaging 2019;49:621–631.

Patients premedicated for a previous reaction to iodinated contrast material have a breakthrough reaction rate 3-4 times the ordinary reaction rate in the general population. Patients receiving premedication for other reasons have a breakthrough reaction rate near 0%. Many patients must receive premedication to prevent one reaction.

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