Safety

Imaging Pregnant and Lactating Patients

Published Online:Oct 14 2015https://doi.org/10.1148/rg.2015150031

Abstract

Considerations, safety issues, and potential adverse effects of ionizing radiation when imaging pregnant and lactating patients are explained to help radiologists adhere to the “as low as reasonably achievable” principle, minimize risk, and adequately address concerns of patients and referring physicians.

As use of imaging in the evaluation of pregnant and lactating patients continues to increase, misperceptions of radiation and safety risks have proliferated, which has led to often unwarranted concerns among patients and clinicians. When radiologic examinations are appropriately used, the benefits derived from the information gained usually outweigh the risks. This review describes appropriateness and safety issues, estimated doses for imaging examinations that use iodizing radiation (ie, radiography, computed tomography, nuclear scintigraphy, and fluoroscopically guided interventional radiology), radiation risks to the mother and conceptus during various stages of pregnancy, and use of iodinated or gadolinium-based contrast agents and radiotracers in pregnant and lactating women. Maternal radiation risk must be weighed with the potential consequences of missing a life-threatening diagnosis such as pulmonary embolus. Fetal risks (ie, spontaneous abortion, teratogenesis, or carcinogenesis) vary with gestational age and imaging modality and should be considered in the context of the potential benefit of medically necessary diagnostic imaging. When feasible and medically indicated, modalities that do not use ionizing radiation (eg, magnetic resonance imaging) are preferred in pregnant and lactating patients. Radiologists should strive to minimize risks of radiation to the mother and fetus, counsel patients effectively, and promote a realistic understanding of risks related to imaging during pregnancy and lactation.

^©RSNA, 2015

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Article History

Received: Feb 21 2015
Revision requested: Apr 6 2015
Revision received: Apr 24 2015
Accepted: Apr 30 2015
Published online: Oct 14 2015
Published in print: Oct 2015

Vol. 35, No. 6

Abbreviations

Abbreviations:
ACOG	American Congress of Obstetricians and Gynecologists
ACR	American College of Radiology
ALARA	as low as reasonably achievable
FDA	Food and Drug Administration
FDG	fluorodeoxyglucose
ICNIRP	International Commission on Non-Iodizing Radiation Protection
ICRP	International Commission on Radiological Protection
V/Q	ventilation-perfusion

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