Safety Of Diagnostic Imaging Techniques During Pregnancy And Lactation
Diagnostic imaging techniques greatly assist the examination and treatment of doctors. Doctors care about proper diagnosis, treatment for patients. But what pregnant and nursing mothers care about is the possible impact on the baby.
Is it wrong that you don't have the same interest? No, actually, doctors are always concerned about the safety of prescribed methods. But answering every patient's questions is not always easy
Image diagnostic techniques
You may hear:, radiography, and Nuclear Medicine. Radiotherapy group: X-ray, computed tomography, Nuclear medicine. The remaining group does not use radiation
Which method is best? There is no best.
Each method has its own advantages, values, and indications. Depending on the conditions and capabilities of the health facility, the patient's condition, etc., the doctor will choose the most appropriate method possible to diagnose or treat the disease.Supersonic
So far there have been no reports of ultrasound harming the fetus or the health of the mother and fetus. Still, it should only be done as directed, necessary. Remember, Medicine is an ever-changing and up-to-date field of study. I do not dare to guarantee that after 10-20 years, people will still say "ultrasound is absolutely safe for pregnancy and for humans in general"
Magnetic Resonance (MRI)
MRI does not use radiation so there are no contraindications for pregnant women.
So far there is no evidence of harm to the fetus even though there are several hypotheses that may cause birth defects. Regarding the risk of malformations, no human studies have been published, animals have not seen an increased risk of the effects.The issue of concern is the use of magnetic interferences in MRI. To increase the quality of diagnostic images, a doctor will inject contrast medicine, such as gadolinium. Gadolinium is a water-soluble substance that can cross the placenta, into fetal circulation and amniotic fluid. Free gadolinium is a poison. The risk and the degree of influence depend on the time of fetal exposure to gadolinium in amniotic fluid. However, some small statistics show that the risk of affecting the fetus does not increase when gadolinium is used in the first 3 months of pregnancy.
Given the available evidence, one can only recommend that: restricting indications if benefits outweigh risks.For nursing women, after 24 hours, no more than 0.04% of gadolinium dose is administered via milk. The fetus absorbs no more than 1% of this amount, so it is still possible to breastfeed.
Methods with radiation
Previously, I had summarized the information through the article, now I only update more on computer science and nuclear medicine.
- Pregnancy period and dose may harm the fetus:
+ Before implantation (0-2 weeks after fertilization): embryonic or unfertilized death: estimated threshold dose of 50-100mGY.
+ Stage of organ differentiation (2-8 weeks after fertilization): birth defects in bones, eyes, gender: estimated dose threshold: 200mGY; growth retardation: 200-250 mGY.
+ Pregnancy 8-15 weeks: mental retardation: 60-310mGY.
Minor disordered: 200 mGY.+ Pregnancy 16-25 weeks: mental retardation: 250-280 mGY.
For computerized tomography of nursing women, the use of contrast material has also been previously recommended not to breastfeed when injected. However, it is now allowed to continue breastfeeding because the amount of iodine absorbed into the fetal digestive tract is very low.
Medical imaging technique
Summary
Ultrasound and MRI do not increase the risk of birth defects, but only when indicated and beneficial for diagnosis.
The radiation dose of conventional CT techniques is very low, lower than the dose that may cause harm to the fetus. However, it is not advisable to specify it widely unless ultrasound and MRI cannot help with diagnosis.
Limit gadolinium use, only when it is more useful for diagnosis.
Breastfeeding may still be given if gadolinium is used.
I summarize the information above is not intended to replace the advice of the doctor who is examining and treating you. Because each patient is a different individual, each disease has its own complexity and comorbidities. You should only read it to understand more information, maybe when your doctor explains, you can be more receptive.
This article is really difficult to understand because of too many technical words, but I still hope to be useful for some people, I cannot "popularize" words any more.
Guidelines for diagnostic Imaging during pregnancy and lactation - ACOG committee opinion - Oct 2017..
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