title: Fetal radiation dose in prophylactic uterine arterial embolization.
abstract: OBJECTIVE
  The purpose of the study was to estimate the absorbed dose (AD) to the fetus for pregnant patients with placenta accreta undergoing fluoroscopy imaging during prophylactic catheterization and uterine artery embolization. We hypothesize that after optimizing the use of the radiation, this endovascular method is safe.
  
  
  METHODS
  Catheterization was performed for seven women before their elective cesarean section. The correct position of the catheter was confirmed by a radiologist using a small bolus of contrast medium and optimized pulsed fluoroscopy imaging. For the AD measurements of the fetus, four radiophotoluminescence dosimeters were placed in the vaginal fornix. Dose area product (DAP), entrance skin exposure (ESE), fluoroscopy time (Tf), and dose rate also was recorded.
  
  
  RESULTS
  The mean values of the radiation exposure for the seven patients were as follows: AD in the vaginal fornix was 11.2 (range 2.2-28.7) mGy, DAP 1,122 (648-2,001) cGy cm(2), ESE 120 (63-184) mGy, Tf 7:31 (5:05-11:35) min:sec, and dose rate 15 (8-21) mGy/min, respectively.
  
  
  CONCLUSIONS
  This study revealed that the AD to the fetus due to the endovascular method can be reduced to be below the risk for developmental disorders when pulsed fluoroscopy with an optimized protocol is used without angiography exposures.
authors.affiliation: Department of Diagnostic Radiology, Oulu University Hospital, POB 50, 90029, Oulu, Finland, anna-leena.manninen@ppshp.fi.
authors.forename: Anna-Leena
authors.initials: AL
authors.lastname: Manninen
authors.forename: Kati
authors.initials: K
authors.lastname: Ojala
authors.forename: Miika T
authors.initials: MT
authors.lastname: Nieminen
authors.forename: Jukka
authors.initials: J
authors.lastname: Perälä
mesh_terms: D000328:Adult; D003287:Contrast Media / Q000008:administration & dosage; D005260:Female; D005333:Fetus / Q000528:radiation effects*; D005471:Fluoroscopy; D006801:Humans; D010921:Placenta Accreta / Q000628:therapy*; D011247:Pregnancy; D011829:Radiation Dosage; D013819:Thermoluminescent Dosimetry; D055357:Uterine Artery Embolization; D014621:Vagina / Q000528:radiation effects
chemical_list: D003287:Contrast Media