Every time the medical examination, when the X -ray radiation department is checked, the doctor will always ask if you are pregnant.If you are pregnant and healthy expectant mothers, many doctors are usually not recommended to take X -rays, but if they are to check whether there is a disease in a certain part of the body, some doctors will also recommend that expectant mothers do a X -ray examination.Therefore, many mothers will have questions: Can I do X -ray and CT scanning radiology inspections during pregnancy?Will it affect the baby in the stomach?Or what if you do you know what to do after you have finished these radiologists?This is a problem. Today, it is mainly combined with the "Expert Suggestion of Radiation Imaging Inspection during pregnancy applications" published in the 3rd China March 3rd issue of March 2020 to learn from everyone.
First of all, as mentioned in the previous article, aside from the dosage, radiation is a hooligan. X -ray and CT inspections do have radiation and related risks. However, a lot of research has confirmed that X -rays have adverse effects on humans.Reach a "threshold"!The potential adverse ending risk of radiation exposure during pregnancy is mainly embryonic death, limited fetal growth, small head deformities, tumors, and long -term intellectual disorders.The "Guidelines for Diagnostic Imaging Image Inspection" jointly released by the American Society of Obstetrics and Gynecologists and the United States Radiology Society pointed out that the impact and risk of X -rays on the fetus mainly depends on two factors: (1) fetal age (2)Radio dose.The 8-15 week of pregnancy is the most sensitive period for radiation. If the pregnant woman is exposed during this time, the risk of the fetus will be significantly increased by the risk of deformed or mental development.EssenceAnimal experiments and retrospective clinical data show that the minimum radiation exposure dosage of the poor ending of the fetus is usually 50 ~ 200 mgy, and large doses of exposure (＞ 1 gy, 1 gy = 1000 mgy) can easily lead to embryonic death, causing birth clinical cases of birth.The minimum exposure dose of severe intellectual disorders is 610 MGY.If the dosage of the fetal absorbing is more than 100mgy, it is recommended to terminate pregnancy.
Simply put, that is,: whether it is an adult or a fetus, the radiation received must be reached to a certain extent to damage; and the dose of diagnostic radiation imaging examination methods commonly used clinically is usually lower than 50 mgy, of whichCommonly used chest X -ray and chest CT fetal radiation exposure dosage is 0.000 5 ~ 0.01 Mgy and 0.01 ~ 0.66 Mgy; a queue study in Sweden found that the fetus exposed during the early and middle pregnancy due to diseases.There is no obvious difference between the grades and the non -exposed group.The long -term impact of radiation exposure mainly considers whether to increase the incidence of tumor.A study conducted pairing analysis of patients with cancer patients in 2 and 690 children, and found that diagnostic radiation imaging examinations during pregnancy will not significantly increase the incidence of child tumors and leukemia.However, there are also retrospective data that the dosage of fetal radiation exposure of 10-20 mgy during early pregnancy may increase the risk of post leukemia by 1.5 ~ 2.0 times, but leukemia
The incidence rate is only 1/3000, and there are many causes of leukemia. The increase in incidence caused by radiation exposure during pregnancy is unclear.In summary
It is said that there is no evidence that the single X -ray and CT imaging examination during pregnancy are harmful to the fetus.
Some pregnant women accidentally undergone radiation imaging examinations. Because their fetal radiation exposure doses are far less than 50 ~ 100 mgy, no push
Recommend medical indicators to terminate pregnancy.However, during pregnancy, especially early pregnancy, special types of examination or multiple examinations are caused by the need
When the accumulated dose of more than 50 ~ 100 mgy can analyze its risks based on the dosage of the gestational week and fetal radiation exposure; at the same time, whether to continue pregnancy also needs to respect the wishes of pregnant women and family members, and refer to relevant laws and regulations.
In addition, in order to improve the degree of recognition of the lesion tissue, a contrast agent may be needed during the CT examination.When using the contrast agent
Consider the nature of gestational weeks, comparison agents, and use pathway.Oral iodine contrast agent does not cause substantial harm because it is not absorbed, but the vein
The iodine contrast agent used through the placenta barrier into the fetal cycle and amniotic fluid.Animal research results show that the use of intravenous iodine comparison during pregnancy
The agent has not seen teratogenic or genetic mutations.There are research on 21 cases of CT examinations at the same time, and neonatal admission to pregnant women using iodine comparison agents
Follow -up, the average weekly pregnancy week of CT examination is 23 weeks, the average delivery week is 38 weeks, and the thyroid function test of 36 h rows after childbirth
No abnormalities were seen.Theoretically, iodine contrast agents have potential effects on fetal thyroid function, but have not been confirmed in human research.Nevertheless, the use of contrast agents should be avoided as much as possible during pregnancy, especially when weighing the advantages and disadvantages that there is additional diagnostic value
The overall principle of radiation imaging examination during pregnancy is: (1) Patient diagnosis benefits are greater than the principle of risk; suspected trauma, cerebral ischemic lesions, aorta clay, small intestinal obstruction, pneumonia and other diseases can also be considered when radiation can also be considered.Sexual imaging examination (2) Follow the principle of low dose as possible.At the same time, it must be noted that even if pregnant women have the clinical application indication of X -rays or CT examinations, they must follow the basic principles of medical ethics and respect the right to know the consent of pregnant women and their families.The importance of radiation imaging examination and the risk of potential fetal damage, and sign the informed consent.However, during the patient’s pregnancy, if it is not urgent, most doctors should consider using no radiation examination, such as B -ultrasound or MRI instead of CT or X -ray.
The protection measures for radiation imaging inspections during pregnancy to reduce the risk of approaching and long -term adverse endings. The use of X -rays, CT and nuclein imaging during pregnancy should be considered as follows: gestational weeks, exposure duration duration, duration duration, Whether to implement protection and exposure distance.Specific measures are: scientific and objective notifications, reasonable selection of inspection methods, correct radiation protection, and follow the principle of ALARA.The purpose is to reduce the anxiety of maternal women and reduce the dosage of radiation exposure without the effect of diagnosis and treatment.Try to avoid early pregnancy.In order to reduce the duration of radiation exposure, it is necessary to be proficient and accurately located, accurate, and reasonable and personalized parameter settings, and inform the patients to correctly complete the inspection.In terms of exposure distance, it is mainly to pay attention to the appropriate position of the patient. It not only guarantees the observation of the lesion area during the examination, but also reduces the exposure of other parts of pregnant women and facilitates radiation protection.When a pregnant woman needs to check the non -pelvic area and abdomen due to the diagnosis of the disease, the abdominal protective device may be considered.
In summary, imaging examinations commonly used in hospitals, especially CT examinations in chest slices and unilateral parts, are safe for pregnant women and fetuses. These are scientific conclusions obtained from a large number of clinical studies;Pregnancy needs to make a decision after the radiation dose and comprehensive examination and assessment. Specifically, please consult the local video department or obstetrician and gynecologist.
 Experts from the application of radiation imaging during pregnancy recommendation [J]. China Magazine Magazine, 2020,23 (3): 145-149.