Fetal uptake of an intravascular radiologic contrast medium

Pb, Dean

doi:10.1055/s-0029-1230698

Cited by 16 publications

(3 citation statements)

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“…Transplacental passage and fetal uptake of an ionic agent such as diatrizoate has been demonstrated in early human pregnancy [5]. Neonatal intestinal opacification secondary to transplacental passage of an ionic contrast medium (Renografin-60) after maternal excretory urography was first documented by Kelleher et al in 1979 [11].…”

Section: Discussionmentioning

confidence: 99%

Transplacental passage of a nonionic contrast agent

et al. 2005

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We report the presence of iopromide in the bowel and urine of a preterm infant, born 10 days after intravenous administration of the nonionic monomer to his mother. Excessive urinary iodine excretion and borderline hyperthyrotropinaemia were observed in the infant. Moreover, crossing of the fetal blood-brain barrier was demonstrated by detection of the angiographic material in CSF and thus direct fetal neurotoxic effects cannot be excluded. Conclusion: These widely used contrast media may cross the placenta and accumulate in various fetal tissues in significant amounts causing possible neonatal toxicity. Therefore the perinatal safety of these diagnostic agents should at least be questioned.

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Section: Discussionmentioning

confidence: 99%

Transplacental passage of a nonionic contrast agent

et al. 2005

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“…Iodinated contrast crosses the placenta into the fetal circulation and is excreted through the kidneys into the amniotic fluid. 44,51,52 Studies of LOCM have demonstrated negligible risk of inducing neonatal hypothyroidism, 44,[53][54][55] and animal testing of LOCM has revealed no evidence of mutagenic or teratogenic effects, but no well-controlled studies in pregnant women have been performed. 44 For ethical reasons, such studies are unlikely.…”

Section: Administration Of Iodinated Contrast To Pregnant Womenmentioning

confidence: 99%

Neuroimaging in Pregnant Women

Chansakul

Young

2017

Semin Neurol

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Choosing the most appropriate diagnostic neuroimaging study for a pregnant woman involves assessing the pretest likelihood of serious treatable neurologic disease, the diagnostic utility of various available computed tomography (CT) and magnetic resonance (MR) modalities, and the risks of each. Of these three elements-pretest differential diagnosis, utility of MRI and CT, and risks of MR and CT-the risk component is perhaps the least well understood by most physicians. We provide a basic review of the intrinsic risks of MRI and CT, particularly radiation biology and radiation safety, as well as the risks pertaining to the use of contrast agents, to reduce provider confusion and anxiety and improve quality, safety, and efficiency of neuroimaging diagnosis in pregnant patients. We believe that a better understanding of the associated very low risks with mother and fetus will reassure the reader that CT remains the most appropriate tool for initial rapid diagnosis of acute neurological conditions in pregnancy and that in urgent situations CT should not be withheld or delayed due to exaggerated concern about radiation. Noncontrast MRI, while not without risk, is generally considered safe in pregnancy, as no evidence of fetal adverse effects has been demonstrated to date. Iodinated CT contrast agents are likely safer than gadolinium-based MRI contrast agents because of gadolinium accumulation in the amniotic fluid and fetal tissue, although no harmful effects of tissue gadolinium accumulation are known. In most but not all pregnant patients presenting with a new or worsening neurological abnormality, the risks intrinsic to the disease will outweigh the risks of imaging. In an individual patient, the pretest probability of serious treatable disease and acuity of presentation will usually suggest an optimal imaging strategy and choice of test. This optimal strategy will also depend on the immediate availability and level of sophistication of the scanners, software, technologists, and radiologists. As such, the standard of care for imaging in pregnancy requires direct consultation between the referring clinician and radiologist to determine the most appropriate strategy and brief documentation of the resulting consensus risk-benefit assessment.

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“…Due to the use of radiation, however, computed tomography (CT) may cause miscarriage, fetal growth restriction, fetal malformation and neonatal mental retardation [1]. In the context of CT scans, io-dinated contrast agents have been reported to pass the placental barrier [2]. Therefore, CT and other similar enhancement scanning technologies should be avoided in pregnant women unless there are strong clinical indications that the benefits of CT outweigh the risks.…”

Section: Introductionmentioning

confidence: 99%

Contrast-enhanced ultrasonography of the placental barrier; the protective umbrella of the fetus during pregnancy

Chen

Zhang

et al. 2022

Med Ultrason

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Aims: Ultrasonography is the preferred technique to evaluate the status of maternal and fetal health during pregnancy. Non-obstetric acute or chronic conditions occurring during pregnancy must be diagnosed as early as possible to permit timely and necessary treatment for the sake of maternal and fetal health. The purpose of this study was to evaluate the safety and value of contrast-enhanced ultrasonography (CEUS) during pregnancy.Materials and methods: This prospective study included 14 pregnant women requiring pregnancy termination and six healthy pregnant women. The 14 pregnant women requiring pregnancy termination underwent CEUS prior to surgery to investigate the pattern of contrast agent diffusion. The six healthy pregnant women did not undergo CEUS. The structure of placentae with and without contrast agent injection were also compared by light microscopy.Results: CEUS analysis failed to identify any signs of contrast agents in the umbilical cord blood and fetus. There were no obvious changes in the morphology of placentae with and without contrast agent injection under light microscope. CEUS identified the need for early treatment in one pregnant woman with an ovarian tumor.Conclusions: Due to the protective effect of the placental barrier on the fetus, CEUS during pregnancy may represent a safe form of imaging technology that can provide valuable information for the diagnosis of non-obstetric acute or chronic disorders and to guide thefuture treatment of pregnant women.

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Fetal uptake of an intravascular radiologic contrast medium

Cited by 16 publications

References 0 publications

Transplacental passage of a nonionic contrast agent

Transplacental passage of a nonionic contrast agent

Neuroimaging in Pregnant Women

Contrast-enhanced ultrasonography of the placental barrier; the protective umbrella of the fetus during pregnancy

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