Pregnancy Screening before Diagnostic Radiography in Emergency Department; an Educational Review
Archives of Academic Emergency Medicine,
Vol. 5 No. 1 (2017),
1 January 2017
,
Page e60
https://doi.org/10.22037/aaem.v5i1.185
Abstract
Radiation exposure during pregnancy may have serious teratogenic effects to the fetus. In modern medical practice, there is an increasing dependence on imaging techniques in most medical specialties. Therefore, checking the pregnancy status before imaging women of child bearing age is essential. Lack of international regulations and standard protocols exposes the patient to unexpected fetal radiation effects and the health professionals to medicolegal suits. Recently, the American Academy of Radiology and the European community of Medical Ionizing Radiation Protection released national guidelines regarding pregnancy screening before imaging potentially pregnant females. However, different methods of pregnancy screening exist among different radiology centers. This review aims to discuss the most recent guidelines for imaging females of childbearing age and highlight the need for an international regulation to guide pregnancy screening before radiological exposure.- Radiation
- Imaging
- Pregnancy
- Screening
- Emergency Department
How to Cite
References
Linton OW, Mettler Jr FA. National conference on dose reduction in CT, with an emphasis on pediatric patients. American Journal of Roentgenology. 2003;181(2):321-9.
Pregnancy I. Medical Radiation ICRP Publication 84. Ann ICRP. 2000;30(1).
McCollough CH, Schueler BA, Atwell TD, Braun NN, Regner DM, Brown DL, et al. Radiation Exposure and Pregnancy: When Should We Be Concerned? 1. Radiographics. 2007;27(4):909-17.
Hennrikus WL, Shaw BA, Gerardi JA. Prevalence of positive preoperative pregnancy testing in teenagers scheduled for orthopedic surgery. Journal of Pediatric Orthopaedics. 2001;21(5):677-9.
WHEELER M, COTÉ CJ. Preoperative Pregnancy Testing in a Tertiary Care Children's Hospital: A Medico-Legal Conundrum. Survey of Anesthesiology. 2000;44(2):123-4.
El-Khoury GY, Madsen MT, Blake ME, Yankowitz J. A new pregnancy policy for a new era. American Journal of Roentgenology. 2003;181(2):335-40.
Applegate K. Pregnancy screening of adolescents and women before radiologic testing: does radiology need a national guideline? Journal of the American College of Radiology. 2007;4(8):533-6.
Ratnapalan S, Bona N, Chandra K, Koren G. Physicians' perceptions of teratogenic risk associated with radiography and CT during early pregnancy. American Journal of Roentgenology. 2004;182(5):1107-9.
Akintomide A, Ikpeme A. Radiation safety of women of the reproductive age: evaluation of the role of referring physicians. Journal of family medicine and primary care. 2014;3(3):243.
Wang PI, Chong ST, Kielar AZ, Kelly AM, Knoepp UD, Mazza MB, et al. Imaging of pregnant and lactating patients: part 1, evidence-based review and recommendations. American Journal of Roentgenology. 2012;198(4):778-84.
Valentin J. Biological effects after prenatal irradiation (embryo and fetus): ICRP Publication 90 Approved by the Commission in October 2002. Annals of the ICRP. 2003;33(1):1-206.
Schauer DA, Linton OW. National Council on Radiation Protection and Measurements Report Shows Substantial Medical Exposure Increase 1. Radiology. 2009;253(2):293-6.
Wakeford R, Little M. Risk coefficients for childhood cancer after intrauterine irradiation: a review. International journal of radiation biology. 2003;79(5):293-309.
Wagner L, Applegate K, Radiology ACo. ACR practice guideline for imaging pregnant or potentially pregnant adolescents and women with ionizing radiation. American College of Radiology Practice Guideline. 2011.
Berlin L. Radiation exposure and the pregnant patient. AJR American journal of roentgenology. 1996;167(6):1377-9.
Radiology ACo. ACR practice guideline for imaging pregnant or potentially pregnant adolescents and women with ionizing radiation. Reston, Va: American College of Radiology. 2008.
Edwards M. Implementation of the Principle of as Low as Reasonably Achievable (ALARA) for Medical and Dental Personnel: Recommendations of the National Council on Radiation Protection and Measurements; Issued December 31, 19901990.
CtAHRfEtLLoI R. Health risks from exposure to low levels of ionizing radiation: BEIR VII phase 2. The National Academies Press; 2006.
Damilakis J, Perisinakis K, Prassopoulos P, Dimovasili E, Varveris H, Gourtsoyiannis N. Conceptus radiation dose and risk from chest screen-film radiography. European radiology. 2003;13(2):406-12.
Winer-Muram HT, Boone JM, Brown HL, Jennings SG, Mabie WC, Lombardo GT. Pulmonary Embolism in Pregnant Patients: Fetal Radiation Dose with Helical CT 1. Radiology. 2002;224(2):487-92.
Chandra V, Dorsey C, Reed AB, Shaw P, Banghart D, Zhou W. Monitoring of fetal radiation exposure during pregnancy. Journal of vascular surgery. 2013;58(3):710-4.
Shaw P, Duncan A, Vouyouka A, Ozsvath K. Radiation exposure and pregnancy. Journal of vascular surgery. 2011;53(1):28S-34S.
Sechopoulos I, Suryanarayanan S, Vedantham S, D'Orsi C, Karellas A. WEâ€Eâ€L100Jâ€05: Radiation Dose to Tissues From Mammography. Medical Physics. 2007;34(6):2606-.
Ahn BY, Kim HH, Moon WK, Pisano ED, Kim HS, Cha ES, et al. Pregnancy-and Lactation-Associated Breast Cancer Mammographic and Sonographic Findings. Journal of ultrasound in medicine. 2003;22(5):491-7.
Raabe A, Müller W-U. Radiation exposure during pregnancy. Neurosurgical review. 2008;31(3):351-2.
James DJ, Cardew P, Warren-Forward HM. Determining the pregnancy status of patients before diagnostic nuclear medicine procedures: the Australian experience. Journal of nuclear medicine technology. 2011;39(3):220-5.
James DJ, Cardew P, Warren-Forward HM. Pregnancy screening strategies for potentially challenging patients before diagnostic nuclear medicine procedures: qualitative survey analysis. Journal of nuclear medicine technology. 2013;41(4):292-8.
Wilcox AJ, Baird DD, Dunson D, McChesney R, Weinberg CR. Natural limits of pregnancy testing in relation to the expected menstrual period. JAMA. 2001;286(14):1759-61.
Valentin J. The 2007 recommendations of the international commission on radiological protection: Elsevier Oxford, UK; 2007.
No S. 478. European communities (medical ionising radiation protection) regulations. Dublin Stationery Office, Dublin. 2002.
Amis ES, Butler PF, Applegate KE, Birnbaum SB, Brateman LF, Hevezi JM, et al. American College of Radiology white paper on radiation dose in medicine. Journal of the american college of radiology. 2007;4(5):272-84.
Malviya S, D'Errico C, Reynolds P, Huntington J, Voepel-Lewis T, Pandit UA. Should pregnancy testing be routine in adolescent patients prior to surgery? Anesthesia & Analgesia. 1996;83(4):854-8.
Polaneczky M, O'Connor K. Pregnancy in the adolescent patient: screening, diagnosis, and initial management. Pediatric Clinics of North America. 1999;46(4):649-70.
Thompson SK, Goldman SM, Shah KB, Chen PC, Wagner LK, Corl FM, et al. Acute non-traumatic maternal illnesses in pregnancy: imaging approaches. Emergency radiology. 2005;11(4):199-212.
Cohan R, Matsumoto J, Quagliano P. ACR manual on contrast media. Am Coll Radiol. 2012:59-63.
Thomsen HS, Morcos SK, Almén T, Bellin M-F, Bertolotto M, Bongartz G, et al. Nephrogenic systemic fibrosis and gadolinium-based contrast media: updated ESUR Contrast Medium Safety Committee guidelines. European radiology. 2013;23(2):307-18.
Gerosa M, Meroni PL, Cimaz R. Safety considerations when prescribing immunosuppression medication to pregnant women. Expert opinion on drug safety. 2014;13(12):1591-9.
Bonanno C, Wapner RJ. Antenatal corticosteroids in the management of preterm birth: are we back where we started? Obstetrics and gynecology clinics of North America. 2012;39(1):47.
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