X Ray and pregnancy

[toledo_il]

Hello everyone,

My wife needs to take an X-Ray (I assume it is a chest X-Ray). There might be a chance that she's pregnant. We don't know yet.

Can someone please, advise as what precautions to take and whether it is safe at all to do the X-Ray at this time.

Please advise...

Thanks,

[Keith Downing, MD]

Hello,

There is often much consternation about receiving X-rays or CT scans in pregnancy because of potential radiation exposure to a developing fetus or even in a well established pregnancy.  Theoretical complications are pregnancy loss, fetal malformations, poor growth or childhood leukemias.  However, concerns regarding most imaging studies that use radiation are grossly over-exaggerated when one considers the actual potential amount of radiation exposure to the fetus when properly shielded.  Even the precautions taken by radiology staff can, at times, be excessive (although checking an hCG is by no means excessive, but rather absolutely appropriate).  

When an imaging study requiring radiation is requested in pregnancy it is always important to consider the medical necessity of the study.  And thus, fetal risks (which are generally negligible), must be weighed against the benefit of aiding diagnostic and subsequent therapeutic accuracy.

I'd have you consider the following information;

There are no studies in humans from which to derive data on risks of ionizing radiation; most of our information is based upon case reports and extrapolation of data from investigations of survivors of the atomic bomb in Japan and the Chernobyl accident.  

The threshold at which an increased risk of congenital malformations is observed in radiation exposed embryos/fetuses has not been definitively determined. The best evidence suggests the risk of malformations is increased at doses above 0.10 Gy (grays), whereas the risk between 0.05 and 0.10 Gy is less clear. It is important to note that even those diagnostic imaging procedures associated with high fetal radiation exposure (eg, abdominal or pelvic CT, barium enema, cystourethrogram) almost never expose the fetus to this level of radiation.

For your wife a CXR or plain film of the chest can limit radiation exposure to 0.02 to 0.04 mGy (2 to 4 mrad) if not less.

Have her talk with the doctor who recommended the study to determine its necessity and then talk with the radiologist about how to limit radiation exposure.  I believe you two have nothing to fear.

best regards,

Dr. Downing

[toledo_il]

Dr. K. Downing,

Thanks alot for the informative advise. Real appreciate it.

I would like to give you alittle more details on our situation.

We are not sure whether my wife is pregnant or not, just yet. Since it is alittle too early for her to test for it. In the mean time she needs to go under a medical examination, which will envolve variouse tests; for example, TB, HIV, and more... which I can't name all, because I don't know their medical terms.

This medical examination is because, I am sponsoring her from US to Canada, and it is a part of the sponsoring process that each applicant needs to undergo.

I am thinking that maybe we should wait until she takes the pregnancy test, and then speak to the radiologist on how to minimize the exposure of the radiation, if the pregnancy test is positive.

But before even doing this, what I am trying to ask is a professional's advise on if/how to proceed with the X-Ray, which you have clearly suggested.

So, I am not quite certain as what this X-Ray is for (I assume it is for TB??), or whether there's an alternative examination to X-Ray.

Thanks once again for your inputs.

Regards,

[grgonsbunny]

x-rays are a form of radiation (gamma i believe)  it is NOT safe to have that measurement of radiation enter her body if she is pregnant.  Last time i had an x-ray done (of ankle and  shoulder) i told the nurse that i was not sure about pregnancy and they had me perform a urine pregnancy test before they would even do the x-rays.