Risk of Ionizing Radiation in Pregnancy: Just a Myth or a Real Concern?

Overview

Journal Europace

Publisher Oxford University Press

Specialties Cardiology & Vascular Diseases
Physiology

Date 2022 Sep 20

PMID 36125209

Authors

Majdi Saada

Erick Sanchez-Jimenez

Ariel Roguin

Affiliations

Soon will be listed here.

Abstract

There are natural concerns regarding the risks posed to the foetus by ionizing radiation exposure during pregnancy. Therefore, many female physicians select to avoid working in an environment associated with ionizing radiation exposure like the catheterization laboratory and even exclude training as electrophysiology, interventional cardiologists, or radiologists. For those already working in this field, pregnancy involves usually a 1-year interruption (pregnancy and maternity leave) to their careers, leading at times to delays in the decision to become pregnant. This review describes the low added risk of malformation/cancer in the offspring, highlight gaps in our understanding, discuss several common wrong beliefs, and recommend how to further decrease radiation dose, especially during pregnancy.

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References

Marci R, Mallozzi M, Di Benedetto L, Schimberni M, Mossa S, Soave I . Radiations and female fertility. Reprod Biol Endocrinol. 2018; 16(1):112. PMC: 6295315. DOI: 10.1186/s12958-018-0432-0. View

Osei E, Kotre C . Equivalent dose to the fetus from occupational exposure of pregnant staff in diagnostic radiology. Br J Radiol. 2001; 74(883):629-37. DOI: 10.1259/bjr.74.883.740629. View

Chandra V, Dorsey C, Reed A, Shaw P, Banghart D, Zhou W . Monitoring of fetal radiation exposure during pregnancy. J Vasc Surg. 2013; 58(3):710-4. DOI: 10.1016/j.jvs.2013.01.052. View

Marcusohn E, Postnikov M, Musallam A, Yalonetsky S, Mishra S, Kerner A . Usefulness of Pelvic Radiation Protection Shields During Transfemoral Procedures-Operator and Patient Considerations. Am J Cardiol. 2018; 122(6):1098-1103. DOI: 10.1016/j.amjcard.2018.06.003. View

Balter S, Brinker J, Kern M, Klein L, Lindsay B, Tommaso C . ACCF/AHA/HRS/SCAI clinical competence statement on physician knowledge to optimize patient safety and image quality in fluoroscopically guided invasive cardiovascular procedures. A report of the American College of Cardiology Foundation/American.... J Am Coll Cardiol. 2004; 44(11):2259-82. DOI: 10.1016/j.jacc.2004.10.014. View

Abuhaimed A, Martin C, Demirkaya O . Influence of cone beam CT (CBCT) scan parameters on size specific dose estimate (SSDE): a Monte Carlo study. Phys Med Biol. 2019; 64(11):115002. DOI: 10.1088/1361-6560/ab0bc8. View

Bottollier-Depois J, Chau Q, Bouisset P, Kerlau G, Plawinski L, Lebaron-Jacobs L . Assessing exposure to cosmic radiation during long-haul flights. Radiat Res. 2000; 153(5 Pt 1):526-32. DOI: 10.1667/0033-7587(2000)153[0526:aetcrd]2.0.co;2. View

Jankowski C . Radiation and pregnancy. Putting the risks in proportion. Am J Nurs. 1986; 86(3):260-5. View

Sarkozy A, De Potter T, Heidbuchel H, Ernst S, Kosiuk J, Vano E . Occupational radiation exposure in the electrophysiology laboratory with a focus on personnel with reproductive potential and during pregnancy: A European Heart Rhythm Association (EHRA) consensus document endorsed by the Heart Rhythm Society (HRS). Europace. 2017; 19(12):1909-1922. DOI: 10.1093/europace/eux252. View

10.

Capranzano P, Kunadian V, Mauri J, Petronio A, Salvatella N, Appelman Y . Motivations for and barriers to choosing an interventional cardiology career path: results from the EAPCI Women Committee worldwide survey. EuroIntervention. 2015; 12(1):53-9. DOI: 10.4244/EIJY15M07_03. View

11.

. Committee Opinion No. 723: Guidelines for Diagnostic Imaging During Pregnancy and Lactation. Obstet Gynecol. 2017; 130(4):e210-e216. DOI: 10.1097/AOG.0000000000002355. View

12.

. Patient dosimetry for x rays used in medical imaging. J ICRU. 2013; 5(2):iv-vi. DOI: 10.1093/jicru/ndi018. View

13.

. The 2007 Recommendations of the International Commission on Radiological Protection. ICRP publication 103. Ann ICRP. 2007; 37(2-4):1-332. DOI: 10.1016/j.icrp.2007.10.003. View

14.

Chen S, Brunet M . Fetal radiation exposure risk in the pregnant neurointerventionalist. J Neurointerv Surg. 2020; 12(10):1014-1017. DOI: 10.1136/neurintsurg-2019-015727. View

15.

Lim H, Agopian A, Whitehead L, Beasley C, Langlois P, Emery R . Maternal occupational exposure to ionizing radiation and major structural birth defects. Birth Defects Res A Clin Mol Teratol. 2015; 103(4):243-54. PMC: 5937122. DOI: 10.1002/bdra.23340. View

16.

Ikenoue T, Ikeda T, Ibara S, Otake M, Schull W . Effects of environmental factors on perinatal outcome: neurological development in cases of intrauterine growth retardation and school performance of children perinatally exposed to ionizing radiation. Environ Health Perspect. 1993; 101 Suppl 2:53-7. PMC: 1519925. DOI: 10.1289/ehp.93101s253. View

17.

Sandborg M, Fransson S, Pettersson H . Evaluation of patient-absorbed doses during coronary angiography and intervention by femoral and radial artery access. Eur Radiol. 2003; 14(4):653-8. DOI: 10.1007/s00330-003-2120-4. View

18.

Bar Joseph N, Reisfeld D, Tirosh E, Silman Z, Rennert G . Neurobehavioral and cognitive performances of children exposed to low-dose radiation in the Chernobyl accident: the Israeli Chernobyl Health Effects Study. Am J Epidemiol. 2004; 160(5):453-9. DOI: 10.1093/aje/kwh231. View

19.

Nyagu A, Loganovsky K, Loganovskaja T . Psychophysiologic aftereffects of prenatal irradiation. Int J Psychophysiol. 1998; 30(3):303-11. DOI: 10.1016/s0167-8760(98)00022-1. View

20.

Stewart A, Webb J, Hewitt D . A survey of childhood malignancies. Br Med J. 1958; 1(5086):1495-508. PMC: 2029590. DOI: 10.1136/bmj.1.5086.1495. View