Abstract
Pregnant women may be exposed to nonionizing, ionizing radiation and contrast media via diagnostic or therapeutic procedures and workplace exposure. When computed tomography or magnetic resonance imaging is performed on a pregnant woman, the effects of exposure to radiation, high magnetic fields and contrast media, which can be risky for a fetus, should be considered. Nonionizing radiation that is not significantly risky for a fetus includes microwave, ultrasound, radio frequency and electromagnetic waves, while ionizing radiation that can be teratogenic, carcinogenic or mutagenic includes particles and electromagnetic radiation. The effects of radiation are associated with the level of exposure and stage of fetal development. Organogenesis (two to seven weeks after conception) and the early fetal period (eight to fifteen weeks after conception) are the most sensitive stages for a fetus. Noncancerous health effects have not been determined at any stage of gestation with less than 50 mGy (5 rad) exposure dose of ionizing radiation. Higher exposure levels may lead to spontaneous abortion, growth restriction, and mental retardation. The risk of cancer is increased regardless of the dose. Although the use of iodinated contrast media is generally thought to be safe during pregnancy, the risk of fetal hypothyroidism should be considered and it should be used only when necessary. The use of gadolinium-based contrast media during pregnancy is controversial because of the lack of clinical data. The purpose of this article is to review the existing literature regarding the prenatal radiation exposure and to discuss fetal risk of radiation.
Highlights
All persons are regularly exposed to radiation such as environmental radiation and radiation from industrial and medical sources
In the past 10 years, radiological examinations performed in pregnant women have increased by 107% and the greatest increase is seen in use of contrast enhanced computed tomography (CT).[1]
Nonionizing radiation and contrast media used in some radiological examinations are considered less risky than ionizing radiation; further studies are required to clearly evaluate the effects of nonionizing radiation and contrast media
Summary
All persons are regularly exposed to radiation such as environmental radiation and radiation from industrial and medical sources. Previous studies reported that this possible risk seems less likely, since sound is attenuated through amniotic fluid and it generally affects the fetus at a level of less than 30 dB.[10] In 1991, the Safety Committee of the Society of MRI stated that MRI may be performed in pregnant women when US is inadequate or insufficient They stated that pregnant women should be informed about the fact that MRI during pregnancy did not have any deleterious effects to date.[11,12]. In 2008, ACR provided guidelines for imaging in pregnant women and estimated fetal risk of various radiation exposure doses in various gestational ages [Table 2].16 These values are provided from animal studies, epidemiological studies of survivors in Japan at the time of atomic bombings and studies of groups exposed to radiation for medical reasons such as radiation therapy for uterus carcinoma.[9]. Exposure to a cumulative dose of less than 50 mGy that is approximately equivalent to the radiation dose of 500 chest radiographies or 100 abdominal CT scans has not been shown to affect pregnancy outcomes compared with control populations exposed to background radiation.[3,4]
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