You may not know that we ourselves are radioactive, and we are exposed to many sources of natural radiation that we cannot avoid. Your developing embryo will not receive a dose that would result in any measurable increased developmental risk.
If you are healthy, young, and have no reproductive or developmental problems or family history of reproductive or developmental problems your risk for birth defects is 3% and for miscarriage, 15%. To convert these to traditional units we have prepared a conversion table.
Toucan also view a diagram to help put the radiation information presented in this question and answer in perspective. Specific facts and circumstances may affect the applicability of concepts, materials, and information described herein.
Answers are the professional opinions of the expert responding to each question; they do not necessarily represent the position of the Health Physics Society. Risk to a fetus during chest radiography is minimal, but reluctance to image pregnant patients can delay diagnosis and affect outcomes.
Despite repeated courses of oral antibiotics her symptoms had slowly worsened, resulting in a referral for specialist review. Urgent bronchoscopy revealed a large vascular tumor obstructing the left upper lobe.
A computed tomography (CT) scan confirmed a hypervascular lesion centered on the left upper lobe bronchus, which was most consistent with a carcinoid tumor, and several lymph nodes in the perivascular space. She had an elective cesarean section at 35 weeks followed by a left upper lobectomy two days later.
Paraffin embedded section showed tumor at the peribronchial margin and one metastatic Hilary lymph node. The clinical team were reluctant to do a chest radiograph, but after discussion with a radiologist they did so at 12 days post-admission, revealing a large anterior mediastinal mass and right pleural effusion (fig 2 ).
A mediastinoscopy confirmed the diagnosis of grade 2 nodular sclerosis Hodgkin’s lymphoma and an ultrasound of the abdomen showed no disease beneath the diaphragm. The patient was found to have stage IIT disease, was treated with pulsed steroids, and was induced at 34 weeks when she delivered a healthy girl by normal vaginal delivery.
After six cycles of chemotherapy a positron emission tomography and CT showed no residual active disease. Symptoms such as coughing and breathlessness may be experienced by healthy pregnant patients, which can result in clinicians failing to consider a full differential diagnosis.
According to the British Thoracic Society Guidelines, a chest radiograph should be undertaken in all patients complaining of a chronic cough (defined as lasting more than eight weeks). These associated symptoms should be ruled out by direct questioning and the guidelines should be followed in all patients, including pregnant women.
The risk posed by the underlying disease process to a pregnant woman and her developing fetus outweighs that of low dose radiation, as highlighted in these two cases. Doctors need to know the relative radiation risk to the fetus, in order to counsel and reassure patients appropriately.
Estimation of the absorbed dose for organs and tissues of a radiological procedure is quantified in Gray (GY). The effective dose to the patient, which takes into account the type of radiation used and the tissues irradiated, is measured in Sievert (SV).
6 They used exposure factors that enabled the estimation of the upper level of doses possible from a chest radiograph. The later the stage of pregnancy the greater the radiation dose, because of the proximity of the gravid uterus.
Most x -rays, such as dental and chest x-rays, will not expose your baby to high enough levels of radiation to cause a problem. A fetus is more at risk from exposure than adults because its cells are dividing and growing rapidly.
If x -rays cause changes to these cells then there is a slight increase in the chance of birth defects and certain illnesses, like leukemia. Health Canada measures radiation from diagnostic x -rays with units called milligray or may.
We are exposed to radiation everyday by the sun, the materials in the surrounding buildings, and in what we do. During your entire pregnancy, your baby will likely be exposed to roughly .5mGy just by the surrounding environment.
Although the risk from X -rays is low, your doctor may advise you to postpone getting unnecessary X -rays until after your baby is born. If your doctor feels X -rays are needed for your particular medical situation, don’t worry.
The amount of radiation your baby will receive is likely to be well within the safe range. On the day of the test, make sure the radiographer knows that you are pregnant, so she can properly shield you.
If you're around radiation at work, talk to your employer about ways to reduce or eliminate your exposure. Don’t forget to download our free app for a day-by-day guide to your pregnancy.
My Pregnancy & Baby Today gives you all the expert advice you need, right at your fingertips. In fact, the American College of Obstetricians and Gynecologists (COG) recommends that pregnant women maintain good oral health by keeping up with such routine dental procedures as X -rays, teeth cleaning, cavity-filling, and root canals.
It's a still a good idea to use a leaded apron to protect your abdomen to minimize your baby's radiation exposure when you've having other parts X-rayed. There are some kinds of X -rays (such as those used to treat disease) that may expose your baby to high doses of radiation, which can cause miscarriage or birth defects as well as some cancers in later life.
In fact, countless research studies have been conducted and these offer conflicting results. Still, the rule of thumb is for the pregnant woman to avoid undergoing unnecessary medical procedures as much as possible.
Maternal illness during pregnancy is not uncommon and sometimes requires radiographic imaging for proper diagnosis and treatment. The accepted cumulative dose of ionizing radiation during pregnancy is 5 rad, and no single diagnostic study exceeds this maximum.
Rare consequences of prenatal radiation exposure include a slight increase in the incidence of childhood leukemia and, possibly, a very small change in the frequency of genetic mutations. Many women become ill while pregnant and require acute medical care, including radiographic imaging with ionizing radiation.
1 Even physicians are at times known to approach this topic in a biased and unscientific manner, leading to poor patient care and inappropriate advice. Because some studies will be performed before a pregnancy is recognized, even doctors not routinely providing prenatal care should understand these issues.
Family physicians must be ready to counsel expectant mothers requiring radiographic imaging and women who have already been exposed. An intravenous pyelogram (MVP) was ordered, but the radiologist refused to perform the study because of concern about radiation exposure to the fetus.
3 A patient's dose of photons is measured in the gray (GY) and the rem, or in the older and more commonly recognized unit, the rad. Much of our information regarding the effects of radiation in humans has come from the study of atomic bomb survivors who were irradiated with high doses while in uteri in Nagasaki and Hiroshima, Japan.
These effects can be grouped into three classic categories: teratogenesis (fetal malformation), carcinogenic (induced malignancy) and muteness (alteration of germ-line genes). The fetal malformations most commonly caused by high-dose radiation are central nervous system (CNS) changes, especially microcephaly and mental retardation.
9 A linear, dose-related association between severe mental retardation and radiation was also found, with the important caveat that most cases followed exposure during weeks 10 to 17 of gestation. 3, 10, 11 This trend reaches 40 percent at 100 rad, although it is not statistically significant at doses generated by diagnostic radiographs.
2 While these doses do fall within the range of that supplied by some radiographic studies, the absolute increase of risk (about one in 10,000) is very small. Nevertheless, physicians should carefully weigh the risks and benefits of any radiographic study and include the mother in the decision-making process whenever possible.
3 The dosage required to double this baseline mutation rate is between 50 and 100 rad, far in excess of the radiation doses occurring in common radiographic studies. Table 2 presents various conclusions from key organizations that may help physicians better understand the overall risks from x -rays and other diagnostic imaging methods.
For example, the general population's total risk of spontaneous abortion, major malformations, mental retardation and childhood malignancy is approximately 286 per 1,000 deliveries. 2, 13 However, if numbers like these are quoted to patients, they are likely to hear only the words “risk,” “abortion,” “mental retardation” and “malignancy.” This situation emphasizes the challenge that doctors face in ensuring good communication during counseling.
Graphic comparison of common radiographic studies with the accepted 5-rad cumulative fetal exposure limit. As part of counseling, physicians should help patients understand that birth anomalies frequently occur spontaneously, with no identifiable cause.
Yet, if after any exposure an anomaly is found, a parent's natural inclination may be to blame radiation, and it will then be difficult to help them understand baseline malformation rates. For example, one author reported on a case of a woman who nearly instituted legal action because of mild syndactyly of her infant's fourth and fifth fingers after third-trimester dental radiographs (exposure 0.0001 rad or less).
Diagnostic x -rays during pregnancy are considered safe, yet physicians should use reasonable caution while remaining sensitive to patients' fears and concerns. Thus, a factual discussion of the nature of the planned examination and its potential outcomes, and documenting consent are appropriate steps before ordering a study.
Women exposed to radiation exceeding a cumulative dose of 5 rad and those with particular concerns about their infant's health may require further evaluation or referral. Concerns of medico legal liability may lead some caregivers to inappropriately withhold needed x -rays, thus jeopardizing the health of both mother and fetus.
Furthermore, it would be difficult to prove that a given radiograph caused harm in light of the high baseline rate of malformations. Ensuring that radiographs are truly indicated and are ordered in accordance with applicable published guidelines will give further support to a physician's course of action at any review.
17 After the nuclear reactor accident in Chernobyl, Russia, 23 percent of pregnancies in Greece were terminated because of unfounded concerns about fetal teratogenicity. 17 While electively terminating an early pregnancy is legal in the United States, it is important that patients and physicians not confuse social issues with medical ones.
Medically, the additional risk imposed by diagnostic radiation is simply too small to justify terminating a pregnancy. A pregnant woman who is ill and requires radiographic imaging faces potential risks from her disease to her own health as well as that of her developing infant's.
Physicians should not hesitate to order a study if an appropriate work-up of the mother requires a specific test to guide diagnosis and treatment. When diagnostic imaging is acutely needed, ultrasonography may represent an alternative to ionizing radiation and is considered safe throughout pregnancy.