Imaging evaluation of nonobstetric conditions during pregnancy: what every radiologist should know

Abstract

<jats:p>Abstract In recent decades, there has been a significant increase in the number of imaging examinations performed on pregnant patients. That increase has occurred across the various modalities, including ultrasound, computed tomography, and magnetic resonance imaging. However, little is known about the risks that these examinations generate for the mother and fetus, related to the use of ionizing radiation or the use of contrast media. When pregnant patients are submitted to imaging studies, the principles of protection established by the International Commission on Radiological Protection should always be respected, to avoid injury to the pregnant woman and the fetus. The potential deleterious effects on the fetus must be weighed against the damage caused by not performing an examination that is clearly indicated, given that a delayed or missed diagnosis can be even more harmful to the health of the mother and of the fetus itself. The purpose of this review article is to address concerns regarding the safety of imaging methods used during pregnancy, as well as to identify typical clinical situations that require decisions to be made about the indication and optimal planning of imaging examinations.</jats:p>

Pregnancy and Dentistry: A Literature Review on Risk Management during Dental Surgical Procedures

“…Doses that are considered safe during the second and third trimesters may be harmful during the first trimester. Nevertheless, high doses of radiation (greater than 0.5 Gy or 50 rad) should be avoided throughout pregnancy [ 88 ].…”

Applicability of the Magnetic Resonance Technique during the Gestational Period: a narrative review

“…Potential risks to the fetus are tissue heating provided by high-frequency pulses, hearing damage from high-intensity noise, and cell migration defects during the first trimester, secondary to the electromagnetic field itself. Despite these theoretical concerns, there are no reports of adverse effects in pregnant women or fetuses undergoing this test [5].…”

“…The acquisition of images in MRI devices of up to 1.5 Tesla is considered safe, and the performance of exams in 3.0 Tesla devices is not recommended, due to the greater potential for tissue heating and the lack of adequate studies to date. The use of MRI is recommended in any gestational period when other methods that do not use ionizing radiation do not clarify the clinical situation, provided that the examination is relevant for the diagnostic-therapeutic definition of the pregnant woman and/or the fetus and that its postponement, until the patient is no longer pregnant, be reckless [5].…”

“…Due to the uncertain effects of the use of paramagnetic contrast media by children who had intrauterine contact with this drug, it is recommended to use it with caution during pregnancy. According to the recommendations of the American College of Radiology, gadolinium should be used only when the benefits justify the potential risks to the fetus, and it should be administered at the lowest possible dose to reach the diagnosis [5].…”

“…The decision on the imaging method to be used in the abdominal evaluation of the pregnant woman is complex and should consider the urgency of diagnostic confirmation, the main clinical hypotheses, the results of previous exams and the risk-benefit for the mother-fetus binomial. The main non-obstetric clinical manifestations requiring abdominal imaging evaluation are those that require urgent attention, such as those causing an acute abdomen (particularly appendicitis and biliary tract diseases), in addition to urinary tract obstructions [5].…”