Radiation and Pregnancy

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I- INTRODUCTION :

The realization of & rsquo; radiological examinations during pregnancy regularly ask health professionals and are major source & rsquo; concerns of pregnant patients

The quest & rsquo; an ongoing pregnancy should be routine in women of childbearing age and to benefit from & rsquo; an X-ray.

For each clinical situation, l & rsquo; review of diagnostic radiology chosen will be the one displaying the best risk / benefit.

Examinations based sultrasons or the magnetic resonance will always preferred to X-ray examinations in pregnant women.

II- DOSES ISSUED AT RADIOLOGICAL :

Doses related to the & rsquo; medical exposure in medicine d & rsquo; urgent concern ray diagnostic imaging tests to X-rays,conventional radiology and computed tomography, or nuclear medicine.

The doses delivered to the & rsquo; uterus during examinations d & rsquo; imaging are expressed in milli GRAY (mGy) and milli becquerel (MBq), doses to the fetus are expressed in mSv mSv.

Estimates of doses & rsquo; irradiation exposing the fetus are less than 50 mGy for most radiological.

III- THE RISKS RADIOLOGICAL DURING PREGNANCY :

The effects of X-rays in pregnancy are abortifacients kind, malformation or carcinogenic.

A- THE risk of malformation :

  • before rimplantation<J8 : c & rsquo; is the law of "all or nothing", i.e. d, c & rsquo; is & rsquo; stop pregnancy or strictly normal course of it.
  • During the phase of & rsquo; s that organogenesis & rsquo; extends from 9th day at 9th week post conception, radiosensitivity is particularly high and the risk of malformation is then majeur.ceci is observed for a threshold & rsquo; irradiation >200mGy.
  • At the stage of fetal maturation that s & rsquo; slack 9th week 9th months pregnant the teratogenic risk is minor.

B- THE carcinogenic risk :

The carcinogenic risk is related to the & rsquo; dose intensity d & rsquo; d & rsquo exposure, or need rapeller to & rsquo; emergency or radiologist d & rsquo; firstly the justification of any examenradiologique exposure to radiation in utero and d & rsquo; secondly to use, equal diagnostic accuracy, to & rsquo; d & rsquo examination; the least radiating imaging.

IV- THE RAY RADIATION X :

  • Seeking pregnancy should be done jointly by the & rsquo; emergency applicant for the & rsquo; exam and the radiologist also especially if the & rsquo; uterus in the case of & rsquo; review requested is in the primary faisseaux or risk & rsquo; be exposed to radiation.
  • In case of proven or probable pregnancy, two conditions are necessary : l & rsquo; asked radiological examination must be the only one to make the diagnosis needed for appropriate care and diagnostic delay endangers the mother and foetus.après patient information risk and & rsquo; examination is performed with the technique less radiant dose estimated d & rsquo; irradiation is mentioned on the minutes of the & rsquo; review.
  • If unrecognized pregnancy : If & rsquo; requested review does not concern & rsquo; uterus is no risk to the fetus.
  • If & rsquo; exploration convetionnelle radiology concerned with the & rsquo; abdomen risk is low though the parent are necessarily informed of the risks despite that & rsquo; they are minors.
  • The réalisationd & rsquo; pelvic CT with realization of several sets of scanner cuts, at this moment,the risk is moderately higher (risk of malformation or mental retardation of & rsquo; unborn child), and this by increasing the dose delivered to the & rsquo; uterus.

V- CONCLUSION :

It is imperative to respect the main precautions in case of realization of & rsquo; radiological investigations in pregnancy and measure the benefit / risk.

Use the & rsquo; & rsquo or ultrasound, MRI when c & rsquo; is possible.

Course of Dr A. ABSURD – Faculty of Constantine