Contrast Agents during Pregnancy: Pros and Cons When Really Needed

Abstract

Many clinical conditions require radiological diagnostic exams based on the emission of different kinds of energy and the use of contrast agents, such as computerized tomography (CT), positron emission tomography (PET), magnetic resonance (MR), ultrasound (US), and X-ray imaging. Pregnant patients who should be submitted for diagnostic examinations with contrast agents represent a group of patients with whom it is necessary to consider both maternal and fetal effects. Radiological examinations use different types of contrast media, the most used and studied are represented by iodinate contrast agents, gadolinium, fluorodeoxyglucose, gastrographin, bariumsulfate, and nanobubbles used in contrast-enhanced ultrasound (CEUS). The present paper reports the available data about each contrast agent and its effect related to the mother and fetus. This review aims to clarify the clinical practices to follow in cases where a radiodiagnostic examination with a contrast medium is indicated to be performed on a pregnant patient.

Reduction of Iodinated Contrast Medium Dose in Computed Tomography Pulmonary Angiography and its Impact on Image Quality: A Narrative Review

“…If a pregnant patient must undergo a CTPA, appropriate scan protocol selection and optimization of scan length may be needed, to minimize exposure of the patient and the developing fetus, whilst maintaining diagnostic quality [70]. Despite the use of ICM is considered safe during pregnancy [71], radiology professionals should carefully weigh the benefits of contrast-enhanced imaging against the potential risk of fetal hypothyroidism and submit pregnant patients in CTPA only when the clinical situation requires doing so, keeping the volume of ICM administered as low as possible [72]. Some patients may experience stress, anxiety or discomfort before or during CTPA.…”

Sentinel lymph node biopsy for breast cancer during pregnancy: A comprehensive update

“…It might be of added value to perform all the ultrasound scan monthly and, if possible, to postdate eventually surgery treatments after delivery. Finally, regarding promotion of early diagnosis, there is much evidence published indicating that supplementation with certain specimens such as inositol and betaine might be helpful to reduce breast density and thereafter achieve earlier diagnosis, especially in women with high breast density 70–75 …”

Influence of COVID-19 infection/vaccination on menstrual regularity and hormonal function in Saudi females of reproductive age

“…Undergoing radiological diagnostic examinations and vaccinations has been significant for mothers during the COVID-19 pandemic. Regarding radiation and contrast media toxicity, studies suggest that the critical dose for foetal health is higher than that of a single radiological examination, and if clinically necessary, these examinations can be safely performed during pregnancy [ 26 ]. There was low acceptance of anti-SAR-CoV-2 vaccines among pregnant women, primarily due to limited knowledge about the disease and a lack of recommendations from health care providers [ 27 ].…”