Clinical perspective on diagnostic X-ray examinations of pregnant patients – What to take into account

Vock, Peter

doi:10.1016/j.ejmp.2017.05.004

Cited by 10 publications

(13 citation statements)

References 20 publications

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“…Knowledge of risks to the conceptus is limited and often has a wide range of uncertainty. Effects may be either stochastic or deterministic, with a rather high threshold [52].…”

Section: Radiation Protection In Pregnancymentioning

confidence: 99%

“…If the fetus is in the direct beam, the procedure should be tailored to reduce the fetus dose (i.e., for radiographic examinations: collimate the beam, increase kVp, remove the anti-scatter grid; for CT: collimate the beam and reduce the scan to the very specific area of interest). Fluoroscopic time must always be limited to the minimum [52].…”

Section: Radiation Protection In Pregnancymentioning

confidence: 99%

“…Every adolescent girl and woman of childbearing age has to be considered as potentially pregnant and should be asked whether she is pregnant or thinks she could be [52,54]. This may be supported by posters presented at the reception of the department, as suggested by the IAEA [55].…”

Section: Imaging the Non-pregnant Womanmentioning

confidence: 99%

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Protecting sensitive patient groups from imaging using ionizing radiation: effects during pregnancy, in fetal life and childhood

et al. 2019

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The frequency of imaging examinations requiring radiation exposure in children (especially CT) is rapidly increasing. This paper reviews the current evidence in radiation protection in pediatric imaging, focusing on the recent knowledge of the biological risk related to low doses exposure. Even if there are no strictly defined limits for patient radiation exposure, it is recommended to try to keep doses as low as reasonably achievable (the ALARA principle). To achieve ALARA, several techniques to reduce the radiation dose in radiation-sensitive patients groups are reviewed. The most recent recommendations that provide guidance regarding imaging of pregnant women are also summarized, and the risk depending on dose and phase of pregnancy is reported. Finally, the risk-benefit analysis of each examination, and careful communication of this risk to the patient, is emphasized.

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“…Knowledge of risks to the conceptus is limited and often has a wide range of uncertainty. Effects may be either stochastic or deterministic, with a rather high threshold [52].…”

Section: Radiation Protection In Pregnancymentioning

confidence: 99%

Section: Radiation Protection In Pregnancymentioning

confidence: 99%

See 1 more Smart Citation

Protecting sensitive patient groups from imaging using ionizing radiation: effects during pregnancy, in fetal life and childhood

et al. 2019

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“…The most common indications for the CT examination during pregnancy are suspected pulmonary embolism, suspected appendicitis, and trauma [3]. These three indications are also covered in a recent review article about the clinical perspective on diagnostic X-ray examinations of pregnant patients [24]. When the scan is appropriately justified and needed, the benefits of the CT scan outweigh the small radiation risk to the fetus.…”

Section: Discussionmentioning

confidence: 99%

Fetal radiation dose in three common CT examinations during pregnancy – Monte Carlo study

et al. 2017

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The three studied examinations provided highly varying fetal doses increasing from sub-mGy level in pulmonary CT angiography to notably higher levels in abdomino-pelvic and trauma scans where the fetus is in the primary exposure range. Volumetric dose distribution offered by MC simulations in an appropriate anthropomorphic phantom provides a comprehensive dose assessment when applied in adjunct to point-dose measurements.

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“…In addition, iodine-containing contrast media may lead to hypothyroidism in the fetus, an additional consideration when performing radiographic studies utilizing contrast material [79]. Counseling of the patient by the referring clinician and by the radiologist is essential in providing informed consent as the benefits and risks of procedures can be opaque and the decision may impart lasting consequences [80]. Impacting 5-7% of all pregnancies, trauma represents an important cause of nonobstetric maternal morbidity and mortality [81].…”

Section: Pregnancy and Reproductive Health Considerationsmentioning

confidence: 99%

Fundamentals of Medical Radiation Safety: Focus on Reducing Short-Term and Long-Term Harmful Exposures

Alers¹,

Salen²,

Yellapu³

et al. 2019

Vignettes in Patient Safety - Volume 4 [Working Title]

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This chapter provides an overview of key topics in the area of radiation safety. Three clinical vignettes will serve to frame the review of the literature around both diagnostic radiation exposure and the risk of radioisotope contamination. Advancement in medical technology is rarely innocuous, and the use of radiation as both means to diagnose and treat certain conditions is not an exception. It is very important for clinicians to review the basics of harmful medical radiation exposure since, although seldom encountered, treatment, and outcomes are time sensitive. The advent of newer technology and the widespread availability of equipment will only serve to increase the prevalence of potentially harmful medical radiation exposure. Moreover, this chapter aims to explore current multidisciplinary endeavors to provide safe and efficient use of radiation in medicine. Solely relying on the medical profession for development of safeguards against harmful medical radiation exposure would be an impossible task. This is why it is crucial for professionals such as health physicists, radiation safety enforcement officers, and policy-makers at the state, national, and international level to establish consensus guidelines aimed toward safe, reliable utilization of radiation in medicine. Part of this interdisciplinary approach needs to focus on accurate education of patients. A thorough assessment of acute radiation syndrome, including diagnosis, treatment, and prognostic indicators is also part of this chapter. Furthermore, principles of screening for, and protection from, radiation contamination are outlined. Finally, areas for further research are identified throughout the chapter. The discussion takes into account both US-based and International research and practice guidelines.

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Clinical perspective on diagnostic X-ray examinations of pregnant patients – What to take into account

Cited by 10 publications

References 20 publications

Protecting sensitive patient groups from imaging using ionizing radiation: effects during pregnancy, in fetal life and childhood

Protecting sensitive patient groups from imaging using ionizing radiation: effects during pregnancy, in fetal life and childhood

Fetal radiation dose in three common CT examinations during pregnancy – Monte Carlo study

Fundamentals of Medical Radiation Safety: Focus on Reducing Short-Term and Long-Term Harmful Exposures

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