Imaging in pregnancy

Eastwood, Kelly‐Ann; Mohan, Aarthi R.

doi:10.1111/tog.12604

Cited by 10 publications

(10 citation statements)

References 41 publications

(110 reference statements)

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“…If this is the case, the investigation may be postponed until after birth or the investigation changed to another method, which is not based on ionizing radiation. Diagnostic imaging should only be performed during pregnancy with an understanding of the risks and benefits of the mother and fetus, the comparative advantages of different modalities and the unique anatomical and physiological issues associated with pregnancy ( 3–5 ) . The woman has the right to know the risk of the examination or treatment for both her own sake and the fetus’ sake.…”

Section: Identification Of Pregnancy and Breastfeedingmentioning

confidence: 99%

X-Ray and Molecular Imaging During Pregnancy and Breastfeeding—when Should We Be Worried?

Mattsson

Leide-Svegborn

Andersson

2021

Radiation Protection Dosimetry

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Some of the ethically most sensitive issues in radiation protection arise at imaging of pregnant—and potentially pregnant—patients and of newborn. This article reviews the current literature and recommendations on imaging during pregnancy and breastfeeding. Risks related to alternative non-ionizing radiation methods are also considered. With few exceptions, exposure of the fetus through radiography, computed tomography (CT) and nuclear medicine imaging can be limited to safe levels, although studies such as abdominal-pelvic CT cannot avoid significant exposure to fetuses. Eight to 10 weeks post-conception, the fetus has a thyroid which starts to concentrate iodide having crossed the placenta barrier resulting in unacceptably high doses to the fetal thyroid after administration of 131I- and even 123I-iodide and other radiopharmaceuticals with a high content of free radioiodine. Many radiopharmaceuticals are excreted through breast milk. Breastfeeding interruption recommendations should be followed to keep the effective dose to the infant below 1 mSv.

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Section: Identification Of Pregnancy and Breastfeedingmentioning

confidence: 99%

X-Ray and Molecular Imaging During Pregnancy and Breastfeeding—when Should We Be Worried?

Mattsson

Leide-Svegborn

Andersson

2021

Radiation Protection Dosimetry

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“…MRI without gadolinium contrast is considered safe in pregnancy. An abdominal CT scan exposes the fetus to a radiation dose of 1.3–35.0 mGy, with levels <50 mGy considered acceptable in pregnancy 17 . Therefore, if CT is clinically indicated, then pregnancy should not be considered a contraindication.…”

Section: Diagnosis Of Acute Pancreatitis In Pregnancymentioning

confidence: 99%

Acute and chronic pancreatitis in pregnancy

O’heney

Barnett

MacSwan

et al. 2021

The Obstetric & Gynaecologis

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Acute pancreatitis can be a life-threatening condition at any stage of life. It is seen in up to 3 in 10 000 pregnancies, with high rates of preterm delivery and maternal mortality rates of up to 3%. Diagnosis in pregnancy can be more challenging, and its aetiology is distributed differently to that of the nonpregnant population. When managing pregnant patients, consideration of implications for the fetus poses an additional challenge. Pregnant patients with chronic pancreatitis need careful assessment, paying attention to nutritional and exocrine needs, pain management and the development of diabetes mellitus. Learning objectivesKnow the symptoms, signs and causes of acute pancreatitis in pregnant women, as well as methods of investigation and classification. Understand how to manage acute pancreatitis. Appreciate the challenges faced by women with chronic pancreatitis and how to manage them, including pregnancy outcome.

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“…[17]. Two studies used IOTA Simple Rules, and only one study stated the level or profession of the ultrasound practitioner [7,17]. In 93 of the 559 masses (17%), an ultrasound impression of either 'malignant', 'complex', or 'unclassifiable' was provided.…”

Section: Quality Assessment Of Studiesmentioning

confidence: 99%

“…The prospective trial by Zanetta et al was the only study that assessed the reliability of ultrasound in the diagnosis of adnexal masses in pregnancy [ 17 ]. Two studies used IOTA Simple Rules, and only one study stated the level or profession of the ultrasound practitioner [ 7 , 17 ]. In 93 of the 559 masses (17%), an ultrasound impression of either ‘malignant’, ‘complex’, or ‘unclassifiable’ was provided.…”

Section: Reviewmentioning

confidence: 99%

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Is Ultrasound a Reliable and Reproducible Method for Assessing Adnexal Masses in Pregnancy? A Systematic Review

Gaughran¹,

Naji²,

Sabbagh³

et al. 2021

Cureus

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In this study, we aimed to systematically review the current evidence regarding the diagnostic accuracy of ultrasound in assessing adnexal masses in pregnancy. The Cochrane Register of Controlled Trials, PubMed, and EMBASE databases were searched for all types of clinical studies that utilised ultrasound for the diagnosis of adnexal masses in pregnancy. Only studies that used outcome measures of either histological diagnosis or significant regression of the adnexal mass on imaging follow-up were included. The quality of each study was assessed for risk of bias. The diagnostic performance of ultrasound in each study type was calculated, along with the pooled diagnostic performance of ultrasound in differentiating benign from malignant masses. The initial search yielded 4,915 articles, of which 2,547 qualified for abstract screening. A total of 83 articles were included in this review, including one prospective cohort study, six retrospective observational studies, seven case series, and 69 case reports. In the included studies, the total number of adnexal masses was 559. The mean patient age was 29.2 years (95% confidence interval [CI]: 28.7-29.7), with a mean gestational age at diagnosis of 13.8 weeks (95% CI: 13.2-14.4). The mean quality assessment score was 75%. The International Ovarian Tumour Analysis Simple Rules were used in two articles, whereas subjective impression was used in the remaining 81 articles. The most frequently diagnosed mass was a simple or physiological cyst (35%). The prevalence of malignancy in the entire sample was 46/559 (8%; 95% CI: 34-61%). The overall pooled sensitivity, specificity, positive likelihood ratio, and negative likelihood ratio of ultrasound in detecting ovarian malignancy were 64% (95% CI: 30-88%), 88% (95% CI: 64-97%), 5.6 (95% CI: 1.2-25.4), and 0.4 (95% CI: 0.15-1), respectively. In conclusion, currently, there is a lack of highquality prospective studies to guide the management of adnexal masses in pregnancy. Ultrasound appears to have an adequate accuracy in differentiating benign from malignant masses; however, more research is required to assess the role of ultrasound models, rules, and subjective assessment in pregnancy compared to non-pregnant women.

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Imaging in pregnancy

Cited by 10 publications

References 41 publications

X-Ray and Molecular Imaging During Pregnancy and Breastfeeding—when Should We Be Worried?

X-Ray and Molecular Imaging During Pregnancy and Breastfeeding—when Should We Be Worried?

Acute and chronic pancreatitis in pregnancy

Is Ultrasound a Reliable and Reproducible Method for Assessing Adnexal Masses in Pregnancy? A Systematic Review

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