Another case of transplacental passage of the non-ionic contrast agent ioversol

Abstract

Sir: In a prior issue of Pediatric Radiology, we reported a case of transplacental passage of non-ionic contrast agents resulting in fetal bowel opacification, a mimic of pneumoperitoneum in the newborn [1]. Several months later, we encountered a similar case that we would like to bring to the readers’ attention. A 36-yearold pregnant female with sickle cell disease presented to the emergency room with acute chest pain. The gestational age of the fetus was 34 weeks. The chest radiograph appeared clear. Due to the strong suspicion of a pulmonary embolus, CT angiography of the chest was performed using the nonionic contrast agent ioversol. Ultrasonography demonstrated oligohydramnios. One day later, a healthy baby boy was delivered via an elective cesarean section with Apgar scores of 9 and 9 at birth. Two days later, the baby developed mild abdominal distension. Abdominal radiographs demonstrated relatively mild nonspecific bowel distension with radiological contrast agent opacifying the bowel (Fig. 1). The baby had not had any examinations involving contrast agent since birth. It was presumed that the contrast agent had passed through the placenta during the CT angiography done in the mother just prior to the delivery. Pathological examination of the placenta revealed a small and congested placenta with a large subchorionic