[PUBLICATION] Pregnant woman and CT scan: The ten points every radiologist should know
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A. Cantarinha, R. Moreno, B. Akakpo-Koutoney, J-P. Dillenseger, O. Meyrignac
Introduction Urgent clinical situations may require a CT scan to be performed during pregnancy. At the same time, CT scans may be indicated in pregnancy monitoring (e.g., pelvimetry or uterine content). Moreover, performing a CT scan on a patient unaware of her pregnancy remains a common concern in imaging departments. Indeed, exposure to X-rays coupled with iodine contrast injection regularly raises safety questions. Knowing the recommendations (e.g., exposure doses, best injection practices) is crucial to ensure an examination with the lowest possible risks.
Materials and methods Publications on the management of pregnant women in CT and recommendations from learned societies were studied. Additionally, a statistical analysis was conducted on 125 requests for uterine dose estimation in 65 establishments in France, based on the type of procedure, the number of scans per examination, and the dose delivered to the uterus
Results When substituting a CT scan with a non-irradiating imaging technique is not possible and if the patient consents, the examination can be justified and thus performed. Personalizing the acquisition is recommended. The analysis shows that the majority of requests for uterine dose calculations follow an abdominopelvic CT (110/125) with a median dose of 10 mGy and a maximum of 50 mGy. Regarding the injection of iodine contrast agents during pregnancy, the theoretical risk of hypothyroidism in the newborn has never been demonstrated in the literature..
Conclusion In pregnant women, a CT scan of areas such as the head, neck, thorax, and lower limbs delivers a negligible dose to the unborn child (less than 1 mGy). Following an abdominal-pelvic acquisition, the dose to the uterus is usually below 50 mGy, well below the critical threshold of 100 mGy.
