Safety of Radiology Imaging in Pregnancy

Imaging is the most prescribed test by the medical practitioners these days especially for pregnancy. It is unavoidable for pregnant women and the least amount of imaging exposure causes no harm to the developing fetus inside the mother’s womb. However, the overusing imaging for the pregnant women can pose severe risk to the fetal growth and development. 

MedPiper Technologies and JournoMed in Association with IRIA Kerala had conducted a webinar on the occasion of Mother’s Day on 10th May, 2022, where one of the speakers, Dr. Anvi Skandhan spoke about Safety of Radiologic Imaging During Pregnancy. She addressed the impact of radiation on fetal growth and the abnormalities it causes during and after childbirth. Dr. Anvi K.P. Skandhan, (MD, EDiR, FRCR) is the Lead Consultant Radiologist and Quality Chief at Aster MIMS, Kottakal, Kerala.

During pregnancy, doctors and physicians ideally recommend four types of scans. 

• Doppler Ultrasound Scan

The Doppler ultrasound Scan generates more heat when performed which might affect the fetus. In such a case, the doppler settings are adjusted in such a way that it causes the least damage to both mother and the fetus. 

• MRI Scan

MRI Scan usage can create either thermal or acoustic damage. Thermal damage is subjected to skin level itself. In acoustic damage, the noise produced by the MRI Scan can show an impact on the fetal growth. In such cases, to avoid the acoustics damage, the pregnant women are padded up such that it doesn’t harm the baby inside the womb. 

Intravenous Gadolinium contrast is sometimes applied, however, it can be harmful to the baby. The baby might feed on the gadolinium liquid which can result in medical complications. 

• Computed Tomography

The amount of radiation produced in the computed tomography is high and is generally prescribed when the trauma is involved. When pregnant women are subjected to high levels of radiation (which is unavoidable), it might lead to miscarriage.

Generally at 2-8 weeks the organogenesis occurs and this stage is a very sensitive stage as it is when the fetus starts developing. After 8-15 weeks of fetus development, if exposed to high amounts of radiation, this might lead to mental retardation. If exposed to radiation during the late fetal period i.e. after 15 weeks of pregnancy, obstruction to delivery can occur. The fetal radiation risks are higher in the 1st trimester of pregnancy. 

• Radiography Scan

In Radiography Scan, ionizing radiation is used. The fetus radiation dose below 50 mGy is considered safe and does not cause any harm. Doses above 100 mGy, especially doses above 150 mGy, are viewed as the minimum amount of dosage at which negative fetal consequences will occur. Spontaneous abortion, growth restriction, and mental retardation may occur at higher exposure levels

The speaker explained that aborting of the fetus is only recommended if there is any medical complication or it is only performed after taking the consent from the patient and their family members. 

Dr. Skandhan explains that one need not go for abortion if there is any little exposure to the radiation due to the medical tests that were recommended during the pregnancy. In most cases, doctors recommend Ultrasound or MRI Scan to perform the fetal screening. She does advise doctors to avoid the intravenous gadolinium contrast scan as it might risk the fetus especially if the fetus feeds on the liquid applied on the body during the scan.