Fetal Radiation Dose in Prophylactic Uterine Arterial Embolization

Abstract

This study revealed that the AD to the fetus due to the endovascular method can be reduced to be below the risk for developmental disorders when pulsed fluoroscopy with an optimized protocol is used without angiography exposures.

Foetal Radiation Dose During Prophylactic Occlusion Balloon Placement for Morbidly Adherent Placenta

“…In this study, a dosimeter was placed in the vaginal fornix to estimate the FAD, but found there was no statistically significance difference between this and other dosimetrics such as DAP and skin exposure [26]. In fact some authors have found vaginal dosimetry less accurate as the dosimeters may be excluded from the primary beam [27,28].…”

Data and methods to estimate fetal dose from fluoroscopically guided prophylactic hypogastric artery balloon occlusion

“…To facilitate comparison of current data to corresponding published results, 12 additional simulations were performed to determine absorbed dose at several sites inside the vaginal fornix as shown in Fig. 1(a).…”

“…Previous studies have shown that fetal radiation doses during HABO exhibit a large variation from 0.7 to 28.7 mGy. 12,13 Manninen et al 12 employed dosimeters placed in various locations in the vaginal fornix of seven patients undergoing HABO to provide data on fetal dose. However, the dose measured inside the vaginal fornix cannot be considered a good approximation of dose to the fetus at the ninth month of gestation.…”

“…Literature research has revealed that currently only two articles have been published on this subject. [12][13][14] Manninen et al 12 have estimated fetal radiation dose from HABO by measuring in vivo the absorbed dose to the vaginal fornix. However, radiation doses measured at close but out of the fetal tissue may differ considerably from the actual fetal dose.…”

Retrospective cohort study of prophylactic intraoperative uterine artery embolization for abnormally invasive placenta

“…Fluoroscopy dosages of 100–200 mGy during prophylactic intraoperative UAE have been reported to induce fetal congenital anomalies . In addition, the likelihood of organ malformation and childhood cancer are strongly dependent on the gestational age of the fetus at the time of radiation exposure . The risk of radiation‐induced anomalies at doses of 50 mGy (a 1% chance for mental retardation and a 3% chance for spontaneous birth anomalies) is considered negligible compared with baseline risks for all developmental anomalies .…”