title: Quality initiatives: guidelines for use of medical imaging during pregnancy and lactation.
abstract: The use of computed tomography (CT) and magnetic resonance (MR) imaging has increased tremendously in the past 2 decades. Hence, pregnant and breast-feeding women, although generally healthier than the population at large, are also more likely to require contrast material-enhanced imaging. When a contrast-enhanced CT or MR imaging study is being considered for a pregnant or lactating patient, the potential risks to the fetus related to exposure to radiation, high magnetic fields, or contrast agents must be considered and weighed carefully against the risks of potential misdiagnosis due to withholding contrast agents and imaging studies. Fetal radiation doses up to 1 mGy are considered acceptable; with larger doses, the risk of carcinogenesis approximately doubles, although it remains low in absolute terms. No damage to a developing human fetus caused by MR imaging exposure has been documented. However, caution is advised, and risks and benefits must always be considered before evaluating a pregnant patient with MR imaging. The use of iodinated contrast agents is generally safe during pregnancy; nevertheless, these agents should be used with caution due to the risk of fetal hypothyroidism and should be administered only when the clinical situation clearly requires doing so. The use of gadolinium-based contrast agents during pregnancy remains controversial due to lack of human clinical data and potential toxicity. Use of all contrast agents is considered safe during lactation. It is hoped that this knowledge will help radiologists develop a consensus with their clinical colleagues regarding case management of pregnant and lactating patients.
authors.affiliation: Department of Radiology, Hôtel-Dieu de Montréal, Centre Hospitalier de l'Université de Montréal, 3840 rue Saint-Urbain, Montréal, QC, Canada H2W 1T8.
authors.forename: Emilie
authors.initials: E
authors.lastname: Tremblay
authors.forename: Eric
authors.initials: E
authors.lastname: Thérasse
authors.forename: Isabelle
authors.initials: I
authors.lastname: Thomassin-Naggara
authors.forename: Isabelle
authors.initials: I
authors.lastname: Trop
mesh_terms: D005260:Female; D006801:Humans; D007774:Lactation; D008279:Magnetic Resonance Imaging / Q000009:adverse effects / Q000379:methods / Q000592:standards*; D017410:Practice Guidelines as Topic; D011247:Pregnancy; D011297:Prenatal Exposure Delayed Effects / Q000209:etiology / Q000517:prevention & control*; D011832:Radiation Injuries / Q000209:etiology / Q000517:prevention & control*; D011835:Radiation Protection / Q000592:standards*; D014057:Tomography, X-Ray Computed / Q000009:adverse effects / Q000592:standards*; D014481:United States